Fact-sheet: Omental infarction
Updated on 10/06/2017 at 4:24 PM
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Definition
Omental infarction = ischemic injury of an epiploic appendage.
Greater omentum = fatty apron between the deep aspect of the anterior abdominal wall and the bowel loops and their mesentery, attached to the transverse mesocolon.
In men, its average thickness parallels that of subcutaneous fat. In women: subcutaneous fat predominates over intra-abdominal fat.
Role of the greater omentum:
- protective support of peritoneal viscera.
- role in peritoneal fluid secretion.
- participates in exchanges with blood and lymph.
Clinical features
More often affects adults than children (15% of cases).
- Acute abdominal pain that may mimic appendicitis or cholecystitis.
- Low-grade fever.
- Nausea and vomiting in 1/3 of cases.
Ultrasound
Round/oval hyperechoic lesion that is painful on probe pressure.
CT
"Boat-shaped" fat-density lesion with loss of central lucency reflecting the lipophagic inflammatory reaction.
Adjacent peritoneal thickening.
Management
Conservative medical treatment: analgesics.
Spontaneous resolution.
Differential diagnosis
Appendicitis, cholecystitis.