UNASSIGNED: Omental infarction (OI) is an uncommon cause of acute abdominal pain. A high index of clinical suspicion is required for diagnosis of OI as the incidence is less than 1 %, presenting with abdominal pain. We report primary OI\'s clinical and radiological profile from a single tertiary care hospital in India.
UNASSIGNED: In this retrospective cross-sectional study, the electronic medical and radiology records of patients with abdominal pain were reviewed over seven years (2015-2022). Variables were systematically collected and analyzed.
UNASSIGNED: A total of 22 patients diagnosed with primary OI were included in this study. Male preponderance (63.6 %) was noted with a mean age of 47.45 years (SD ± 13.84; range: 18-72 years). Most patients belonged to class I obesity (according to the Asia-Pacific body mass index classification) with a mean BMI of 26.56 kg/m2 (SD ± 3.21 kg/m2). All patients had abdominal pain as the primary symptom, with a mean duration of 8.64 days (SD ± 10.15; range: 1-42 days). The most common locations of pain were the right hypochondrium (27.3 %) and diffuse (27.3 %), followed by the right iliac fossa (18.1 %). Most (95.45 %, n=21/22) patients were treated conservatively, and only one required surgical intervention.
UNASSIGNED: Primary OI is a rare and benign cause of acute abdomen. Obesity is a risk factor but does not correlate with the size or severity of OI. Radiological imaging, like a computed tomography (CT) scan, is essential for diagnosis. A conservative management line should be the first approach in treating primary OI before considering surgical options.

UNASSIGNED: Omental infarction is a rare pediatric disease. Ultrasound is a useful modality for a non-invasive pre-operative differential diagnosis between inflammatory conditions (as appendicitis) and omental infarction, especially by detecting immobility of the omentum adhered to the abdominal wall (\"tetherd fat sign\"). However, this is a dynamic sign that cannot be documented in a static image with B-mode technique. The goal of this work is to incorporate the versatile function of motion mode (M-mode) into omental infarction diagnosis to describe how the M-mode is useful in the evaluation of fat motion in children suspected of having omental infarction. In 2019 we suggested a new Ultrasound sign named \"tethered fat sign\" for an accurate non-invasive diagnosis of omental infarction in children. This finding was observed in 6 of the 234 seen children of our previous study with 4 laparoscopic confirmed diagnosis.
UNASSIGNED: From January 2019 to July 2021, we evaluated 195 children (91 boys and 104 girls, from 3 to 15 years) admitted to our Santobono-Pausilipon Children Hospital with acute right-sided abdominal pain. Abdominal ultrasound was performed to all the patients and the investigation of \"tethered fat sign\" was always included.
UNASSIGNED: In 7 patients ultrasound showed the presence of a hyperechoic oval mass localized in the right upper abdominal quadrant and in 2 of these M-mode documented a normal subhepatic fat moving during respiratory movements in relation with the abdominal wall. The remaining 5 patients had an omental infarction showed as a subhepatic motionless mass tethered to the abdominal wall on M-mode. In these patients, a sonographic follow-up was performed every 15 d for 2 months showing a progressive reduction in size of the right-sided hyperechoic mass.
UNASSIGNED: In the evaluation of all children who showed the presence of the \"tethered fat sign\" the use of M-mode provide a certified image in diagnostic ultrasound.

Partial infarction of the great omentum is a rare cause of abdominal pain and may present as a surgical emergency. Omental infarction might occur due to its torsion, but cases without obvious cause are reported. Risk factors related to this condition are overweight, obesity, abdominal trauma, recent abdominal surgery, hypercoagulability, postprandial vascular congestion and an increase in intra-abdominal pressure. Because of the condition\'s rarity, most patients are treated with surgery and the diagnosis is established intraoperatively. Preoperative diagnosis allows successful conservative treatment with analgesics and anti-inflammatory drugs. This case reports a young female patient with class III obesity presented with spontaneous partial infarction of the great omentum treated with laparoscopy.

Omental infarction (OI) is a rare condition with an overall incidence of less than 0.3%. It can occur spontaneously or can be secondary to trauma, surgery, and inflammation. While previously a diagnosis of exclusion, due to development in imaging technology, OI can now be identified based on CT findings. OI symptoms can mimic an acute abdomen, prompting potentially unnecessary surgical exploration. Treatment options range from conservative management to interventional radiology or surgical resection of the infarcted omentum. We are presenting the first case of OI following robotic-assisted inguinal hernia repair. This case highlights the importance of considering OI in differential diagnoses for patients presenting with acute abdominal pain, the utility of imaging workup in identifying OI, and guidance for conservative treatment approaches to reduce unnecessary surgical intervention.

BACKGROUND: Omental artery aneurysm (OAA) is an extremely rare visceral artery aneurysm. Ruptured OAAs are associated with a high mortality rate. Transcatheter arterial embolization (TAE) has been used to treat OAA in recent years. However, the risk of omental ischemia due to TAE remains unclear. Therefore, this study aimed to investigate the efficacy and safety of TAE of OAA as a first-line treatment.
METHODS: Fifteen patients with true aneurysms or pseudoaneurysms who underwent OAA-TAE between 1 April 2010 and 31 December 2022 were included in this study. The technical and clinical outcomes, the incidence of omental infarction after TAE as a major complication, OAA-TAE techniques, radiological findings on computed tomography angiography and angiogram, and patient characteristics were evaluated.
RESULTS: Fifteen patients (nine men, six women; age, 69.8 ± 18.59 years) underwent TAE of OAAs (mean aneurysm size of 9.30 ± 6.10 mm) located in the right gastroepiploic (n = 9), left gastroepiploic (n = 1), and epiploic (n = 5) arteries. All patients with ruptured (n = 6) and unruptured (n = 9) OAA successfully underwent TAEs using coils, n-butyl-2-cyanoacrylate, or gelatin sponges. Hepatic artery thrombosis and coil migration were observed during the procedure; however, these adverse events were manageable. Transfusion of red blood cell units (4.66 ± 1.63 units) was required only in cases with ruptured OAAs after TAE. Additional surgery or TAE due to rupture or rerupture of OAA and omental infarction was not required during the postoperative and follow-up periods.
CONCLUSIONS: The OAA-TAE can effectively treat ruptured and unruptured OAAs, and the risk of omental infarction after OAA-TAE may not be high.

We report the case details of a 65-year-old Japanese man with an omental abscess that was discovered 43 days after he underwent a laparoscopic proximal gastrectomy for gastric cancer. His chief complaint was mild abdominal pain that had persisted for several days. The abscess was diagnosed as a rare postoperative complication. We hesitated to perform a reoperation given the invasiveness of general anesthesia and surgery, plus the possibility of postoperative adhesions and because the patient\'s general condition was stable and he had only mild abdominal pain. Percutaneous drainage using a 10.2-F catheter was performed with the patient under conscious sedation and computed tomography-fluoroscopy guidance, with no complications. After the procedure, the size of the abscess cavity was remarkably reduced, and 23 days later the catheter was withdrawn.

Acute abdominal pain is a common presentation in emergency departments, often attributed to a myriad of potential causes. Among these, acute appendicitis remains a frequently diagnosed culprit. However, this case report presents a 32-year-old male who arrived at the emergency department with severe right lower quadrant abdominal pain, characterized by localized tenderness and guarding. The initial clinical diagnosis pointed to acute appendicitis. Before surgical intervention, a computed tomography scan was conducted and revealed a focal area of fat stranding, consistent with omental infarction, while the appendix appeared normal. The patient\'s management involved pain control and supportive care, leading to a complete resolution of abdominal pain at a two-week follow-up. This case emphasizes the significance of including omental infarction in the spectrum of diagnoses for acute abdominal pain, underlining the potential to prevent unnecessary surgical interventions.

BACKGROUND: Omental torsion is due to the twisting of the omentum along its axis and is observed in young male patients. The first description of omental torsion was first made by Eitel in 1899.
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.

Peri-gastric appendagitis followed associated with gastro-hepatic ligament/lesser omentum hemorrhagic infarction has not been well investigated yet. With an accurate radiological diagnosis of peri-gastric appendagitis, even in case of hemorrhagic infarction, the patient can receive supportive measures for the self-limited pain and can forgo surgery, endoscopy, and further invasive testing.

Omental infarction (OI) is a rare cause of acute abdominal pain, which is benign and self-limited. It is diagnosed by imaging. The etiology of OI is either idiopathic or secondary and due to torsion, trauma, hypercoagulability, vasculitis, or pancreatitis.
Here, we present a case of OI in a child with acute severe right upper quadrant pain. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Correct diagnosis of OI via imaging can prevent unnecessary surgery.