Subasinghe Duminda, Jayasinghe Ravindri, Ranaweera Gayani, Kodithuwakku Uditha
Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
The University Surgical Unit, The National Hospital of Sri Lanka, Colombo, Sri Lanka.
SAGE Open Med Case Rep. 2022 Nov 7;10:2050313X221135982. doi: 10.1177/2050313X221135982. eCollection 2022.
Omental infarction is a rare but a sinister cause of acute abdomen. Preoperative diagnosis is challenging due to its rare nature. It poses nonspecific abdominal signs that can be easily mistaken with other more common intra-abdominal pathologies. We report a case of a 37-year-old male patient presented with right lower quadrant abdominal pain with an elevation of inflammatory markers. His cross-sectional imaging did not a reveal specific diagnosis; therefore, a diagnostic laparoscopy was performed which revealed a non-inflamed appendix and an inflammatory mass formed by the ischemic omentum attached to the ascending colon. Diagnostic laparoscopy and subsequent laparotomy revealed spontaneous omental infarction. The histology of the resected specimen was in keeping with the omental necrosis. This case reflects the importance of considering omental infarction in patients presenting with abdominal pain and raised inflammatory markers. He made an uneventful recovery following surgery.
大网膜梗死是一种罕见但凶险的急腹症病因。由于其罕见性,术前诊断具有挑战性。它表现出非特异性的腹部体征,很容易与其他更常见的腹腔内病变相混淆。我们报告一例37岁男性患者,表现为右下腹腹痛且炎症标志物升高。其横断面成像未显示明确诊断;因此,进行了诊断性腹腔镜检查,结果显示阑尾未发炎,且有一个由附着于升结肠的缺血大网膜形成的炎性肿块。诊断性腹腔镜检查及随后的剖腹手术显示为自发性大网膜梗死。切除标本的组织学检查结果与大网膜坏死相符。该病例反映了对于出现腹痛和炎症标志物升高的患者考虑大网膜梗死的重要性。他术后恢复顺利。