Cianci Roberta, Filippone Antonella, Basilico Raffaella, Storto Maria Luigia
Section of Radiological Sciences, Department of Clinical Sciences and Bioimages, G. d'Annunzio University of Chieti, SS. Annunziata Hospital, Via dei Vestini-Colle dell'Ara, 66013 Chieti, Italy.
Emerg Radiol. 2008 Jan;15(1):51-6. doi: 10.1007/s10140-007-0631-z. Epub 2007 Jul 3.
Idiopathic segmental infarction of the greater omentum is a rare disorder presenting with nonspecific clinical symptoms that may mimic a variety of acute abdominal conditions. We describe the diagnosis and treatment of two patients who had idiopathic infarction of the greater omentum and presented with localized abdominal pain, mimicking acute cholecystitis and acute diverticulitis, respectively. Patients underwent unenhanced multidetector-row computed tomography (CT) examination, which demonstrated the characteristic features of omental infarction, consisting of a heterogeneous density fatty mass, containing hyperattenuating streaks, located in the greater omentum, between the anterior abdominal wall and the colon; a moderate amount of free peritoneal fluid was also present. There were no other pathological abdominal findings. Giving persisting and worsening symptoms, both patients underwent laparoscopy with resection of the necrotic portion of the omentum. Pathology confirmed the preoperative diagnosis. Unenhanced CT allows us to obtain a reliable diagnosis of omental infarction in patients with acute abdominal pain and may help in selecting the appropriate medical or surgical therapy.
特发性大网膜节段性梗死是一种罕见疾病，表现为非特异性临床症状，可能类似于多种急性腹部疾病。我们描述了两名特发性大网膜梗死患者的诊断和治疗情况，他们分别表现为局部腹痛，分别酷似急性胆囊炎和急性憩室炎。患者接受了非增强多层螺旋计算机断层扫描（CT）检查，显示出大网膜梗死的特征性表现，即位于大网膜、前腹壁和结肠之间的密度不均匀的脂肪块，内有高密度条纹；还存在中等量的游离腹腔积液。未发现其他腹部病理表现。由于症状持续且加重，两名患者均接受了腹腔镜检查并切除了大网膜坏死部分。病理证实了术前诊断。非增强CT使我们能够对急性腹痛患者的大网膜梗死做出可靠诊断，并可能有助于选择合适的药物或手术治疗方法。
