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自发性大网膜梗死作为右下腹疼痛的罕见鉴别诊断:一例病例报告及文献复习

Spontaneous omental infarction as a rare differential for right iliac fossa pain: A case report and review of the literature.

作者信息

Lee Su Jin, Le Khang Duy Ricky, Mark Peter

机构信息

Department of General Surgical Specialties The Royal Melbourne Hospital Melbourne Victoria Australia.

Department of Radiology The Royal Melbourne Hospital Melbourne Victoria Australia.

出版信息

Clin Case Rep. 2024 Jul 3;12(7):e9151. doi: 10.1002/ccr3.9151. eCollection 2024 Jul.

Abstract

Omental infarction is a rare cause of acute abdominal pain, often benign and self-limiting. The significance of infarction lies in the fact that it can mimic other abdominal pathologies including appendicitis, cholecystitis, pancreatitis, or reflux disease. Diagnostic laparoscopy provides the definitive diagnosis of omental infarction, but it is invasive and limited due to resources. Computed tomography of the abdomen and pelvis has been considered the gold standard to diagnosing omental infarction when a non-invasive diagnostic approach is required. Additionally, ultrasound can also be used alternatively for children. Currently, there is no consensus in the diagnosis and management of patients with imaging-proven omental infarction. Spontaneous infarcted omentum must be considered by surgeons and radiologists as a rare cause of acute abdominal pain as patients can experience good outcomes with either conservative or operative approach. However, conservative management must only be considered in stable patients where alternative pathology is unlikely.

摘要

网膜梗死是急性腹痛的罕见原因,通常为良性且具有自限性。梗死的重要性在于它可能酷似其他腹部病变,包括阑尾炎、胆囊炎、胰腺炎或反流性疾病。诊断性腹腔镜检查可明确网膜梗死的诊断,但它具有侵入性且因资源限制而受到局限。当需要采用非侵入性诊断方法时,腹部和盆腔计算机断层扫描被认为是诊断网膜梗死的金标准。此外,超声检查也可用于儿童。目前,对于经影像学证实的网膜梗死患者的诊断和管理尚无共识。外科医生和放射科医生必须将自发性梗死的网膜视为急性腹痛的罕见原因,因为无论是采用保守治疗还是手术治疗,患者都可能获得良好的预后。然而,保守治疗仅适用于不太可能存在其他病变的稳定患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd27/11220499/8acea9739445/CCR3-12-e9151-g003.jpg

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