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Abstract：
BACKGROUND: Omental infarction (OI) is an infrequent cause of acute abdominal pain and there is no consensus on whether conservative or surgical treatment is the best strategy when performing positive CT diagnosis.
OBJECTIVE: To assess which of the two treatments is the most commonly adopted and compare outcomes in terms of success rate in resolution of symptoms and hospital length of stay.
METHODS: Case report and case series of patients with abdominal pain and positive diagnosis by CT of omental infarction.
METHODS: PubMed, Science Direct and Google Scholar in combination with cross-referencing searches and manual searches of eligible articles from January 2000 to June 2018.
METHODS: Patients older than 18 years of age.
METHODS: Patient characteristics and results were summarized descriptively. Categorical variables were assessed by chisquare test or Fischer\'s exact test, and continuous variables by the Wilcoxon-Mann-Whitney or Kruskal-Wallis test. Risk factors for failure of the conservative management were identified using multivariate logistic regression.
RESULTS: 90 articles were included in the final analysis (146 patients). 107 patients (73.3%) received conservative treatment with a failure rate of 15.9% (patients needing surgery) and 39 patients (26.7%) received surgery as first treatment. The mean hospital length of stay was 5.1 days for the conservative treatment group and 2.5 days for the surgery group with statistically significant differences (p = 0.00). Younger age and white blood cells count ≥12000/μl were predictive factors of conservative treatment failure.
CONCLUSIONS: Although conservative treatment is effective in most patients, surgery has advantages in terms of hospital length of stay.
OBJECTIVE: To assess which of the two treatments is the most commonly adopted and compare outcomes in terms of success rate in resolution of symptoms and hospital length of stay.
METHODS: Case report and case series of patients with abdominal pain and positive diagnosis by CT of omental infarction.
METHODS: PubMed, Science Direct and Google Scholar in combination with cross-referencing searches and manual searches of eligible articles from January 2000 to June 2018.
METHODS: Patients older than 18 years of age.
METHODS: Patient characteristics and results were summarized descriptively. Categorical variables were assessed by chisquare test or Fischer\'s exact test, and continuous variables by the Wilcoxon-Mann-Whitney or Kruskal-Wallis test. Risk factors for failure of the conservative management were identified using multivariate logistic regression.
RESULTS: 90 articles were included in the final analysis (146 patients). 107 patients (73.3%) received conservative treatment with a failure rate of 15.9% (patients needing surgery) and 39 patients (26.7%) received surgery as first treatment. The mean hospital length of stay was 5.1 days for the conservative treatment group and 2.5 days for the surgery group with statistically significant differences (p = 0.00). Younger age and white blood cells count ≥12000/μl were predictive factors of conservative treatment failure.
CONCLUSIONS: Although conservative treatment is effective in most patients, surgery has advantages in terms of hospital length of stay.
摘要：
■Omental梗塞（OI）是急性腹痛的罕见原因，在进行CT阳性诊断时，保守治疗还是手术治疗是最佳策略尚无共识。
■评估两种治疗方法中哪一种是最常用的，并比较症状缓解成功率和住院时间的结果。
■病例报告及病例系列腹痛患者经CT诊断为网膜梗死阳性。
■PubMed,从2000年1月至2018年6月，ScienceDirect和GoogleScholar结合交叉引用搜索和手动搜索符合条件的文章。
■18岁以上患者。
■对患者特征和结果进行描述性总结。分类变量通过chisquare检验或Fischer精确检验进行评估，和连续变量的Wilcoxon-Mann-Whitney或Kruskal-Wallis检验。使用多变量逻辑回归确定保守管理失败的危险因素。
■90篇文章纳入最终分析（146例患者）。107例（73.3％）患者接受保守治疗，失败率为15.9％（需要手术的患者），39例（26.7％）患者接受手术作为第一治疗。保守治疗组的平均住院时间为5.1天，手术组为2.5天，差异有统计学意义（p=0.00）。年龄较小和白细胞计数≥12000/μl是保守治疗失败的预测因素。
■虽然保守治疗对大多数患者有效，手术在住院时间方面具有优势。
■评估两种治疗方法中哪一种是最常用的，并比较症状缓解成功率和住院时间的结果。
■病例报告及病例系列腹痛患者经CT诊断为网膜梗死阳性。
■PubMed,从2000年1月至2018年6月，ScienceDirect和GoogleScholar结合交叉引用搜索和手动搜索符合条件的文章。
■18岁以上患者。
■对患者特征和结果进行描述性总结。分类变量通过chisquare检验或Fischer精确检验进行评估，和连续变量的Wilcoxon-Mann-Whitney或Kruskal-Wallis检验。使用多变量逻辑回归确定保守管理失败的危险因素。
■90篇文章纳入最终分析（146例患者）。107例（73.3％）患者接受保守治疗，失败率为15.9％（需要手术的患者），39例（26.7％）患者接受手术作为第一治疗。保守治疗组的平均住院时间为5.1天，手术组为2.5天，差异有统计学意义（p=0.00）。年龄较小和白细胞计数≥12000/μl是保守治疗失败的预测因素。
■虽然保守治疗对大多数患者有效，手术在住院时间方面具有优势。
