Liao S Y
Zhonghua Yi Xue Za Zhi (Taipei). 1989 Nov;44(5):331-5.
Among a variety of acute abdomens, acute torsion of omentum, first reported by Marchett in 1851, is least suspected under the impression of, most commonly, acute appendicitis and then acute cholecystitis, mesenteric thrombosis, ovarian cyst, perforated peptic ulcer, etc. A 52-years-old woman was admitted on May 2, 1987 with anorexia, nausea and RLQ pain for 2 days. Physical examination revealed tenderness, guarding and rigidity over RLQ. White cell count was 12.100/mm3. A reducible hernia was found in the right inguinal region. The operation through McBurney's incision showed blood-stained fluid. Appendix was slightly congested. A solid, gangrenous mass was palpated at right iliac fossa that disclosed a completely tight torsion of omentum twisting 6 times counterclockwise with distal infarction. Segmental omentectomy, appendectomy and hernioplasty were done. The patient's recovery was uneventful. This case emphasizes the necessity of routine examination of the omentum during the course of abdominal exploration especially when serosanguinous fluid was encountered in the peritoneal cavity.
在各种急腹症中，大网膜急性扭转于1851年由马尔凯蒂首次报道，在通常被误诊为急性阑尾炎、其次是急性胆囊炎、肠系膜血栓形成、卵巢囊肿、消化性溃疡穿孔等疾病的情况下，最不容易被怀疑。一名52岁女性于1987年5月2日入院，有厌食、恶心和右下腹疼痛2天。体格检查发现右下腹有压痛、肌卫和强直。白细胞计数为12100/mm³。在右侧腹股沟区发现一个可复性疝。经麦氏切口手术发现有血性液体。阑尾轻度充血。在右髂窝可触及一个实性、坏疽性肿块，发现大网膜完全扭转紧密，逆时针扭转6次，远端梗死。行节段性大网膜切除术、阑尾切除术和疝修补术。患者恢复顺利。该病例强调了在腹部探查过程中常规检查大网膜的必要性，尤其是当腹腔内遇到血性液体时。
