Abstract
A 32-year-old man visited our department as an outpatient with a 2-day history of right lower abdominal pain. Physical findings showed pain on pressure and rebound tenderness localized to the right lower abdomen from the right flank region. Abdominal computed tomography showed an elevated area of adipose tissue that was intraperitoneally localized from the right flank just below the navel. Since the patient had no history of trauma of findings of torsion, idiopathic segmental infarction of the greater omentum was diagnosed. After admission, the patient was fasted and treated conservatively with antibiotics, but showed no improvement in symptoms. On hospital day 3, he underwent laparoscopic omentectomy. In surgical findings, part of the right greater omentum was discolored dark red, and edema was observed, with adhesion to the abdominal wall. Postoperative course was favorable, and he was discharged on postoperative day 3. Idiopathic segmental infarction of the greater omentum is a rare disease that presents with acute abdominal symptoms, and is often difficult to distinguish clinically from acute appendicitis. In many previous cases, this pathology was first diagnosed on surgery, but imaging has enabled preoperative diagnosis. We encountered and report herein a case of idiopathic segmental infarction of the greater omentum that was diagnosed preoperatively on CT and treated using laparoscopic surgery.
