Torsion of the Greater Omentum: A Case Report on Differential Diagnoses

• DOI: https://doi.org/10.22533/at.ed.515721126010611

• Palavras-chave: Greater omentum; Acute abdomen; Omental torsion; Inguinal hernia; Laparotomy.

• Keywords: Greater omentum; Acute abdomen; Omental torsion; Inguinal hernia; Laparotomy.

• Abstract:

  Greater omental torsion is a rare cause of acute abdomen, often confused with more prevalent conditions, such as acute appendicitis. Preoperative diagnosis is difficult due to nonspecific clinical presentation and the low incidence of the condition. We report the case of a 35-year-old male patient with acute abdominal pain in the right iliac fossa, associated with loss of appetite, and no significant gastrointestinal symptoms. Abdominal ultrasound suggested obstructed acute appendicitis, and a surgical approach was indicated. Intraoperatively, torsion of the greater omentum with distal necrosis was identified, associated with a pre-existing right inguinal hernia, with no signs of inflammation in the cecal appendix. A segmental omentectomy was performed, with a favorable postoperative course. This case reinforces the importance of considering omental torsion as a differential diagnosis in patients with acute abdomen, especially in the presence of ipsilateral inguinal hernia, thereby avoiding incomplete surgical approaches and reducing the risk of recurrence.