8th Baltic Congress of Radiology

Abdominal Radiology

poster abstract

Omental infarction is a rare cause of an acute abdomen with a nonspecific clinical presentation and can usually be mistaken with other pathologies. To avoid unnecessary surgical interventions, omental infarction should be considered and excluded by performing radiological imaging in patients with an acute abdomen. The aim of the study is to evaluate the imaging results and determine the main symptoms that are associated with omental infarction.

A retrospective study was performed in the Radiology department from June 2020 to October 2021. Six patients (age 8 to 73 years old, median age 26 years old) with clinically and radiologically confirmed omental infarction were enrolled.

Nonspecific abdominal pain was the leading complaint of all patients. The most common pain sites were the area under the right rib cage presented in 3 cases (50%) and the epigastric region in 2 patients (33%). The symptom period ranged from 1 to 4 days. One (16.6%) patient was asymptomatic as the infarction zone in the omentum was found incidentally during the control CT scan after a gastrectomy. Two patients (33%) presented with nausea or loss of appetite. Vomiting throughout the disease was also observed in 2 patients (33%). Three patients (50%) presented with tenderness in the abdomen, and one (16.6%) had a subfebrile fever. The abdominal X-ray was performed in 4 cases (67%) with no specific findings. Ultrasound (US) was performed for 5 patients (83.4%), and in three patients (50%), local fat tissue infiltration was observed. The US findings of 2 issues (33%) were unrelated to omental infarction. Abdominal computed tomography (CT) was performed in every case. The CT revealed localized, a well-circumscribed fatty inflammatory areas in all cases (100%). The CT scans confirmed the diagnosis of omental infarction. Five patients (83.4%) were treated conservatively, and 2 of them (33%) also received antibiotic therapy. In one case (16.6%), a laparotomy was performed as a CT scan showed signs of possible internal hernia. During the surgery, the affected part of the omentum was removed. All the patients (100%) had a positive outcome.

Omental infarction can present with nonspecific signs, often masquerading as other abdominal illnesses. Generally, it compromises conservative management. CT is the gold standard method for omental infarction diagnosis.

Omental infarction is a rare cause of an acute abdomen with a nonspecific clinical presentation and can usually be mistaken with other pathologies. The aim of the study is to evaluate the imaging results and determine the main symptoms that are associated with omental infarction. Solving this mystery would help to evade the unnecessary surgical interventions for the disease that could most of the time be treated conservatively.

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