A Case of Single-incision Laparoscopic Resection for Omental Torsion

Abstract

A 54-year-old man presenting with right lower abdominal pain was referred to our hospital with suspected appendicitis. A plain CT performed at the previous clinic showed atypical findings for appendicitis. The inflammatory reaction was moderate. Contrast-enhanced CT at our hospital on the day after admission revealed twisting of the omentum with a local mass of fat density. An emergency single-incision laparoscopic omentectomy was performed under the diagnosis of omental torsion, because of persistence of the symptoms with conservative treatment. Laparoscopic examination revealed adhesion of the necrotic omental mass to the right side of the abdominal wall and ileocecum, and we resected the necrotic part of the omentum. The postoperative course was uneventful and the patient was discharged on the fourth postoperative day. Omental torsion is relatively rare and is often misdiagnosed as acute appendicitis. We report the first adult case of idiopathic omental torsion treated by single-incision laparoscopic surgery.