A Case of Primary Torsion of the Greater Omentum Diagnosed with Computed Tomography prior to Laparoscopic Surgery

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 32; no. 4; pp. 801 - 803
• Main Authors: Kimura, Toshihisa, Takeuchi, Kazuo
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 31.05.2012
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.32.801

A 34-year-old woman was referred to our hospital with suspected appendicitis because of right lower abdominal pain which had lasted from the day before admission. She had tenderness and Blumberg sign in the right abdomen. On blood analysis, the white blood cell count was within the normal range and C-reactive protein was 2.84mg/dL. Abdominal ultrasonography revealed an irregular mass under the abdominal wall of the right abdomen, and a concentric whorl-like structure was seen on abdominal CT. A laparoscopic operation was performed under a diagnosis of torsion of the grater omentum. Torsion of the grater omentum is classified into the primary idiopathic type and secondary type. This case was diagnosed as primary idiopathic omental torsion because no cause of the torsion could be found. Primary torsion of the omentum presenting with acute abdomen is a relatively rate entity. This disease presents difficulty in preoperative diagnosis and is often diagnosed as acute appendicitis. Therefore, it is important to keep this disease in mind as one of the acute abdominal diseases. Endoscopic surgery is useful to treat this disease.