Dr. Ertan Beyatlı

What is Omental Torsion?

(Update: ) - Digestive System Diseases

Omental Torsion is one of the causes of acute abdomen. In this case, the omentum rotates around its own axis and clamps the vessels leading to the distal part of the omentum, causing necrosis and infarction. Extreme in patients stomach pain complaints develop. Omental torsion is usually seen in adults.

Omentum torsion usually Acute Appendicitis It causes almost the same complaints and symptoms as the disease. Tomography for diagnosis (Abdominal CT) has an important role.

What is the omentum?

Omentum (Latin "apron“) Is a medical term referring to the fatty peritoneal layers surrounding the abdominal organs. It consists of two parts, the large and small omentum. Same time 'Abdominal Police, policeman of the abdomenIt is called '. The omentum plays a surprising role in the immune response and the growth of some cancers. It is known to secrete obesity related hormones.

Symptoms and Examination Findings

Preoperative omentum torsion is difficult to diagnose clinically. Preoperative correct diagnosis is in the range of 0.6-4.8%.

Omental torsion usually occurs in adults (of both sexes). The bent part of the omentum tends to be localized in a right-sided segment, thus causing sudden onset and signs of peritoneal irritation on the right side of the abdomen. Status nauseamay be associated with vomiting or low-grade fever. Abdominal mass can be palpated in half of the patients.

This acute right-sided pain with rebound sensitivity is often acute appendicitis, acute cholecystitis or confused with twisted ovarian cysts. The presence of free serosanguineous fluid in laparotomy associated with a normal appendicitis, gallbladder or pelvic organs should alert the surgeon to the possibility of omental torsion.

Laboratory studies

Complete blood count (CBC) can reveal mild leukocytosis, which occurs in two-thirds of omental torsion cases.

Imaging studies

Reports may show a characteristic appearance of omentum torsion on ultrasonography (USG) and computed tomography (CT). However, as this disease can mimic other surgical emergencies, extensive radiological studies are often time-consuming and unnecessary.

Omentum Torsion CT view
Omentum Torsion CT view

CT can show a concentric distribution of fibrous and fatty layers that approach radially to torsion. On the other hand, USG can show a complex mass and a mixture of solids and hypoechoic regions.

Case Report

Patient: Omental torsion and necrosis due to infarction developed in a 55-year-old female patient.

Results: A patient who was admitted to our hospital on 29.05.2015 with sudden abdominal pain, nausea, vomiting and anorexia. (Zonguldak

FM: In the physical abdominal examination of the patient, local tenderness, rebound and defense were detected in the right abdomen.

Abdominal USG and CT: omentum infarction, acute appendicitis

Treatment: The patient was operated under general anesthesia and laparotomy + partial omentum resection was performed.

Omentum Torsion - necrotic omentum removed during surgery. Ertan BEYATLI, MD PhD - Zonguldak / Turkey
Omentum Torsion - necrotic omentum removed during surgery. Ertan BEYATLI, MD PhD - Zonguldak / Turkey
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