PRIMARY OMENTAL TORSION AFTER PARTURITION

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 65; no. 3; pp. 814 - 817
• Main Authors: KUROSAKA, Yoshiyuki, KIRIYAMA, Masato, ITOU, Hiroshi, TAKEGAWA, Shigeru, KOJIMA, Yasuhiko, WATANABE, Kishichirou
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2004
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.65.814

We report a rare case of primary omental torsion after parturition. Ten days after normal delivery, a 26-year-old woman felt colicky pain in the right lower abdomen. She was transferred to our hospital with the suspition of a malignant tumor in following initial surgery under a diagnosis of ovarian torsion. Physical examination palpated a hard mass with tenderness and muscular defense in the umbilicus. Blood analysis showed the white blood cell count in the normal range, but CRP was slightly increased. Abdominal computed tomography (CT) showed a fat density mass with concentric linear strands and a right ovarian cyst. In laparotomy under a diagnosis of omental torsion, we found a 8.0×2.0cm mass, built up of concentrated omentum under the umbilicus. This mass and a right ovary were resected. Primary omental torsion was definitively diagnosed due to the lack of other findings in the abdominal cavity. If acute abdomen shows no gastrointestinal symptom and mild inflammatory findings compared to a severe stimulant peritoneal sign, abdominal CT, which shows characteristic findings of omental torsion, is highly useful in the differential diagnosis of this disease.