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网膜梗死表现为右上腹疼痛,病例报告。

Omental infarction present with right upper quadrant pain, case report.

作者信息

Aolayan Khulud, Obaid Ghassan, Fadel Khaled, Alotaibi Abdulrahman M

机构信息

Department of Surgery, King Fahad Hospital, Medina, Saudi Arabia.

Department of Surgery, Dr. Samir Abbas Hospital, Jeddah, Saudi Arabia.

出版信息

J Surg Case Rep. 2021 Nov 30;2021(11):rjab521. doi: 10.1093/jscr/rjab521. eCollection 2021 Nov.

Abstract

Omental infarction is a rare cause of pain and must be considered in the differential diagnosis of acute abdomen. It arises in any quadrant that contains omentum when a compromised blood supply takes place. We report a morbid obese 45-year-old male with Diabetes mellitus, dyslipidemia and coronavirus-disease-related pneumonia 2 months prior to his emergency presentation with acute epigastric and right upper quadrant pain. The patient was investigated by computed tomography (CT), and the provisional diagnosis was biliary colic from gallbladder stone. The patient's pain was severe and not compatible with biliary colic. Diagnostic laparoscopy approached and an incidental finding of omental necrotic area. Excision of the infarcted omentum in addition to cholecystectomy was done. The patient's postoperative course was uneventful, and he was discharged home after 2 days. In our case, the CT image did not discover mental changes that may help us to make a preoperative diagnosis.

摘要

网膜梗死是一种罕见的疼痛原因,在急腹症的鉴别诊断中必须予以考虑。当血液供应受损时,它会出现在任何含有网膜的象限。我们报告一例45岁病态肥胖男性,在因急性上腹部和右上腹疼痛急诊就诊前2个月患有糖尿病、血脂异常和冠状病毒病相关肺炎。患者接受了计算机断层扫描(CT)检查,初步诊断为胆囊结石引起的胆绞痛。患者疼痛剧烈,与胆绞痛不符。进行了诊断性腹腔镜检查,意外发现网膜坏死区域。除胆囊切除术外,还切除了梗死的网膜。患者术后恢复顺利,2天后出院。在我们的病例中,CT图像未发现有助于术前诊断的网膜改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf8/8634541/589880a4e769/rjab521f1.jpg

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