Freed J S, Edelman S
Am J Gastroenterol. 1976 Oct;66(4):386-9.
The diagnosis of primary torsion of the omentum is a diagnostic enigma and is made almost exclusively at laparotomy. The difficulty is enhanced when the patient has a chronic problem mimicking a specific entity, e.g. peptic ulcer disease. The case presented is an example of this situation. The patient's history and acute presentation were compatible with chronic peptic ulcer disease with acute perforation. At laparotomy, the findings of torsion of the right lower omentum with infarction, along with marked scarring of the remainder of the greater omentum explained the clinical picture. Torsion of the greater omentum, therefore, must be added to the list of differential diagnoses when one is considering peptic ulcer disease.
原发性大网膜扭转的诊断是一个诊断难题，几乎只能在剖腹手术时才能确诊。当患者有模仿某种特定疾病（如消化性溃疡病）的慢性问题时，诊断难度会增加。本文所呈现的病例就是这种情况的一个例子。患者的病史和急性症状与伴有急性穿孔的慢性消化性溃疡病相符。在剖腹手术中，右下大网膜扭转伴梗死的发现，以及大网膜其余部分的明显瘢痕形成，解释了临床表现。因此，在考虑消化性溃疡病的鉴别诊断时，必须将大网膜扭转列入鉴别诊断清单。
