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Torsion of the greater omentum: two case reports

INTRODUCTION: Torsion of the omentum is a benign self-limiting disorder, which is difficult to diagnose because the main symptoms are similar to those of other abdominal diseases. Most of the published cases had been diagnosed during operation via direct eye view. According to several studies, it is...

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Autores principales: Alexiou, Konstantinos, Ioannidis, Argyrios, Drikos, Ioannis, Sikalias, Nicolaos, Economou, Nicolaos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507315/
https://www.ncbi.nlm.nih.gov/pubmed/26163136
http://dx.doi.org/10.1186/s13256-015-0641-5
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author Alexiou, Konstantinos
Ioannidis, Argyrios
Drikos, Ioannis
Sikalias, Nicolaos
Economou, Nicolaos
author_facet Alexiou, Konstantinos
Ioannidis, Argyrios
Drikos, Ioannis
Sikalias, Nicolaos
Economou, Nicolaos
author_sort Alexiou, Konstantinos
collection PubMed
description INTRODUCTION: Torsion of the omentum is a benign self-limiting disorder, which is difficult to diagnose because the main symptoms are similar to those of other abdominal diseases. Most of the published cases had been diagnosed during operation via direct eye view. According to several studies, it is important that the correct preoperative diagnosis is made as omental torsion can be treated conservatively in most cases without any complications avoiding surgical intervention. However, patients should be under clinical and laboratory observation in order to detect symptoms that would lead to surgical intervention in which case a laparoscopy is the appropriate surgical treatment. CASE PRESENTATION: Torsion of the great omentum is a rare cause of acute abdominal pain which is usually misdiagnosed. In this study we report two cases, a 52-year-old Greek woman and a 68-year-old Greek man, who presented at our emergency room with symptoms such as right lower quadrant pain and tenderness similar to acute appendicitis. In both cases a surgical exploratory laparotomy of the abdomen revealed a twisted heavily congested segment of the right part of the greater omentum accompanied by intra-abdominal serosanguinous fluid. CONCLUSIONS: Greater omental torsion is difficult to diagnose preoperatively. It presents as acute abdominal pain located more often in the right iliac fossa. It is very important to make a correct preoperative diagnosis because omental torsion is a benign self-limiting disorder that can be treated conservatively, avoiding laparotomy. When a patient’s clinical, laboratory and radiological findings worsen or diagnosis is doubtful then laparoscopy is the appropriate method for diagnosis and treatment.
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spelling pubmed-45073152015-07-21 Torsion of the greater omentum: two case reports Alexiou, Konstantinos Ioannidis, Argyrios Drikos, Ioannis Sikalias, Nicolaos Economou, Nicolaos J Med Case Rep Case Report INTRODUCTION: Torsion of the omentum is a benign self-limiting disorder, which is difficult to diagnose because the main symptoms are similar to those of other abdominal diseases. Most of the published cases had been diagnosed during operation via direct eye view. According to several studies, it is important that the correct preoperative diagnosis is made as omental torsion can be treated conservatively in most cases without any complications avoiding surgical intervention. However, patients should be under clinical and laboratory observation in order to detect symptoms that would lead to surgical intervention in which case a laparoscopy is the appropriate surgical treatment. CASE PRESENTATION: Torsion of the great omentum is a rare cause of acute abdominal pain which is usually misdiagnosed. In this study we report two cases, a 52-year-old Greek woman and a 68-year-old Greek man, who presented at our emergency room with symptoms such as right lower quadrant pain and tenderness similar to acute appendicitis. In both cases a surgical exploratory laparotomy of the abdomen revealed a twisted heavily congested segment of the right part of the greater omentum accompanied by intra-abdominal serosanguinous fluid. CONCLUSIONS: Greater omental torsion is difficult to diagnose preoperatively. It presents as acute abdominal pain located more often in the right iliac fossa. It is very important to make a correct preoperative diagnosis because omental torsion is a benign self-limiting disorder that can be treated conservatively, avoiding laparotomy. When a patient’s clinical, laboratory and radiological findings worsen or diagnosis is doubtful then laparoscopy is the appropriate method for diagnosis and treatment. BioMed Central 2015-07-11 /pmc/articles/PMC4507315/ /pubmed/26163136 http://dx.doi.org/10.1186/s13256-015-0641-5 Text en © Alexiou et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Alexiou, Konstantinos
Ioannidis, Argyrios
Drikos, Ioannis
Sikalias, Nicolaos
Economou, Nicolaos
Torsion of the greater omentum: two case reports
title Torsion of the greater omentum: two case reports
title_full Torsion of the greater omentum: two case reports
title_fullStr Torsion of the greater omentum: two case reports
title_full_unstemmed Torsion of the greater omentum: two case reports
title_short Torsion of the greater omentum: two case reports
title_sort torsion of the greater omentum: two case reports
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507315/
https://www.ncbi.nlm.nih.gov/pubmed/26163136
http://dx.doi.org/10.1186/s13256-015-0641-5
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