Laparoscopic diagnosis and treatment of primary segmental omental torsion with infarction mimicking acute appendicitis: a rare cause of acute abdominal pain

Awe JAA (MBBS Ibadan; FWACS; FICS; FRCS)

Consultant General Surgeon and Associate Professor of Surgery, Department of Surgery, College of Health Sciences, Igbinedion University, Okada; Edo State, Nigeria.

E-mail: doset2007@yahoo.com

Accepted 14 March, 2014

Abstract

Torsion of the greater omentum is a rare condition with symptoms resembling those of acute appendicitis and is infrequently diagnosed preoperatively. Knowledge of this entity is important to the surgeon because it mimics other causes of acute surgical presentations. Treatment is surgical excision and laparoscopic approach is an excellent diagnostic and therapeutic tool. This case stresses the fact that when unremarkable appendiceal pathology is found with the presence of serosanguineous fluid in the right paracolic gutter especially at laparoscopy mandates inspection of the omentum to exclude torsion possibly with infarction as a possible diagnosis if the bowel, gall bladder and pelvic organs are normal. This case report is the first one documented in this hospital diagnosed and treated laparoscopically.

Keywords: Omentum, Infarction, Appendix, Laparoscopy.