METHODS: A 35-year-old male presented with right iliac fossa pain, nausea, occasional vomiting and loss of appetite for four days. His clinical and radiological findings were suggestive of acute appendicitis. However, he was diagnosed with greater omental torsion intraoperatively and successfully managed with laparoscopic omentectomy.
CONCLUSIONS: Omental torsion is a rare condition with a low incidence. Preoperative diagnosis of omental torsion continues to be a challenge as the symptoms reported in the literature are usually confused with other abdominal pathologies such as appendicitis or cholecystitis etc. Preoperative US or CT scans are mandatory, and these procedures can accurately accomplish the pre-operative diagnosis. In search for the treatment of choice, laparoscopy proved its effectiveness as a diagnostic tool since it allows for confirming the diagnosis, evaluating the severity of the ischemia, and ruling out other surgical pathologies and therapeutic tools. At the same time, the open surgery approach can be described in many cases as being too invasive.
CONCLUSIONS: Greater omental torsion should be considered a differential diagnosis in all patients with acute abdominal emergencies.
方法:一名35岁男性患者出现右髂窝疼痛,恶心,偶尔呕吐和食欲不振四天。他的临床和放射学检查结果提示急性阑尾炎。然而,术中诊断为大网膜扭转,并通过腹腔镜网膜切除术成功治疗。
结论:肛门扭转是一种罕见的疾病,发病率低。网膜扭转的术前诊断仍然是一个挑战,因为文献中报道的症状通常与其他腹部病理如阑尾炎或胆囊炎等相混淆。术前必须进行US或CT扫描,这些程序可以准确地完成术前诊断。在寻找治疗的选择,腹腔镜检查证明了其作为诊断工具的有效性,因为它可以确认诊断,评估缺血的严重程度,排除其他手术病理和治疗工具。同时,在许多情况下,开放手术方法可以被描述为过于侵入性。
结论:大网膜扭转应被视为所有急性腹部急症患者的鉴别诊断。