Primary torsion of the greater omentum mimicking duodenal ulcer

Abstract

The diagnosis of primary torsion of the omentum is a diagnostic enigma and is made almost exclusively at laparotomy. The difficulty is enhanced when the patient has a chronic problem mimicking a specific entity, e.g. peptic ulcer disease. The case presented is an example of this situation. The patient's history and acute presentation were compatible with chronic peptic ulcer disease with acute perforation. At laparotomy, the findings of torsion of the right lower omentum with infarction, along with marked scarring of the remainder of the greater omentum explained the clinical picture. Torsion of the greater omentum, therefore, must be added to the list of differential diagnoses when one is considering peptic ulcer disease.