Kamr Wael H, Taman Saher E, Tawfik Ahmed I
Department of Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Pol J Radiol. 2019 Oct 7;84:e389-e396. doi: 10.5114/pjr.2019.89441. eCollection 2019.
Abdominal fat necrosis is a rare cause of abdominal acute pain, classified into primary or secondary according to the cause. Primary fat necrosis includes epiploic appendagitis or idiopathic infarction of the greater omentum. This retrospective study focuses on multislice computed tomography (MSCT) findings and diagnosis of primary abdominal fat necrosis as a cause of acute abdomen.
This was a retrospective study with 20 patients included, presented to emergency room with acute abdominal pain diagnosed as primary fat necrosis. Retrospective evaluation was made of the patients' clinical data, presentation, CT studies done at the acute stage, and their primary and final diagnosis.
Twenty patients (eight male and 12 female, mean age 45 years, age range 20-70 years) diagnosed with abdominal fat necrosis (primary omental infarct) on CT imaging between October 2014 and June 2018 were evaluated. Clinically, five patients were suspected to be cholecystitis¸ eight patients as appendicitis, and four patients as diverticulitis. In addition, three patients had renal colic and were suspected to have ureteric stones; they showed suspected areas of abnormal fat density in non-contrast CT of the urinary tract. Idiopathic omental infarctions were detected in 13 patients on CT; all were on the right side. Laparoscopic excision was done for all. The other seven patients had epiploic appendagitis, seen on the left side, treated with conservative management.
Primary fat necrosis, although rare, can be presented as acute abdomen. MSCT is the main diagnostic tool for diagnosis of omental infraction and differentiation between other causes of acute abdomen.
腹部脂肪坏死是腹部急性疼痛的罕见病因，根据病因可分为原发性或继发性。原发性脂肪坏死包括网膜附件炎或大网膜特发性梗死。本回顾性研究聚焦于多层螺旋计算机断层扫描（MSCT）对原发性腹部脂肪坏死作为急腹症病因的表现及诊断。
这是一项回顾性研究，纳入20例因急性腹痛就诊于急诊室且被诊断为原发性脂肪坏死的患者。对患者的临床资料、临床表现、急性期进行的CT检查以及其初步和最终诊断进行回顾性评估。
对2014年10月至2018年6月期间CT成像诊断为腹部脂肪坏死（原发性网膜梗死）的患者进行了评估。这些患者中，男性8例，女性12例，平均年龄45岁，年龄范围20 - 70岁。临床上，5例患者疑似胆囊炎，8例疑似阑尾炎，4例疑似憩室炎。此外，3例患者有肾绞痛，疑似输尿管结石；在泌尿系统非增强CT上显示有可疑脂肪密度异常区域。CT检查发现13例患者为特发性网膜梗死，均位于右侧，全部接受了腹腔镜切除术。另外7例患者为网膜附件炎，位于左侧，接受了保守治疗。
原发性脂肪坏死虽罕见，但可表现为急腹症。MSCT是诊断网膜梗死及鉴别其他急腹症病因的主要诊断工具。
