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网膜扭转;一例罕见的急腹症。病例报告。

Omental torsion; an unusual case of acute abdomen. Case report.

作者信息

Carrillo Luis Miguel, de Jesús Marín-López José, Díaz-Barrera Oscar, Olvera-Rodríguez Jesús Alejandro, Gutiérrez-Gutiérrez Laura Yazmín, Herrera-Gutiérrez Jacaranda

机构信息

Department of General Surgery, Hospital General Tercer Milenio, Aguascalientes, Mexico.

Department of General Surgery, Hospital General Tercer Milenio, Aguascalientes, Mexico.

出版信息

Int J Surg Case Rep. 2023 Feb;103:107901. doi: 10.1016/j.ijscr.2023.107901. Epub 2023 Jan 14.

Abstract

INTRODUCTION AND IMPORTANCE

Omental torsion as a cause of acute abdominal pain is extremely rare and difficult to diagnose preoperatively given the non-specific clinical picture.

PRESENTATION OF CASE

We report the case of an adult male who went to the emergency room due to abdominal pain, presented clinical symptoms and laboratory findings consistent with acute appendicitis but was diagnosed intraoperatively with omental torsion and associated necrosis, which was successfully treated by laparoscopic omentectomy.

DISCUSSION

It is a rare entity with a low incidence. The symptoms of the cases reported in the literature are usually confused with other abdominal pathologies such as appendicitis or cholecystitis, so preoperative diagnosis continues to be a challenge. The treatment of choice is the laparoscopic approach, since it allows confirming the diagnosis, evaluating the severity of the ischemia, and ruling out other surgical pathologies.

CONCLUSION

It is important to consider omental torsion as another differential diagnosis of acute abdomen, which can be satisfactorily resolved via laparoscopy, thus avoiding the development of complications associated with its natural evolution.

摘要

引言与重要性

网膜扭转作为急性腹痛的一个病因极为罕见,鉴于其临床表现不具特异性,术前很难诊断。

病例呈现

我们报告一例成年男性病例,该患者因腹痛前往急诊室,其临床症状和实验室检查结果与急性阑尾炎相符,但术中诊断为网膜扭转并伴有坏死,通过腹腔镜网膜切除术成功治疗。

讨论

这是一种罕见疾病,发病率较低。文献报道的病例症状通常与阑尾炎或胆囊炎等其他腹部疾病相混淆,因此术前诊断仍然是一项挑战。首选的治疗方法是腹腔镜手术,因为它能够确诊、评估缺血的严重程度,并排除其他外科疾病。

结论

将网膜扭转视为急性腹痛的另一种鉴别诊断很重要,通过腹腔镜检查可以令人满意地解决该问题,从而避免与其自然发展相关的并发症的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d02e/9883202/89ef5f784655/gr1.jpg

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