Abstract
A 46-year-old woman was admitted with a 3-day history of colicky abdominal pain. She had guarding and tenderness at McBurney's point. Her blood results showed an increased inflammatory response, and abdominal dynamic contrast-enhanced computed tomography showed a pelvic mass that was continuous with the omentum and also showed cut-off of feeding blood vessels. We suspected that torsion of the omentum may have caused ischemic necrosis in the omental mass. We then performed a diagnostic laparoscopic examination to evaluate whether it could be surgically removed. We confirmed that there was good mobility of the mass and that there were no adhesions between the mass and surrounding tissues. The procedure was converted into a laparotomy, and the omental mass, together with a portion of the omentum, were successfully removed. Postoperative pathological examination showed a lipoma with congestive bleeding and degenerative necrosis. In this case, laparoscopic examination was useful for diagnosis. In addition to a literature review, we present the characteristic findings of omental torsion caused by omental lipoma.
