2017 Volume 53 Issue 7 Pages 1324-1327
Omental torsion is a rare cause of acute abdomen in children. We present a case report of an 11-year-old girl who was diagnosed as having omental torsion with ileal volvulus. She complained of acute abdominal pain and nausea that started 2–3 hours before arrival. She experiences a similar abdominal pain with vomiting that recurs once a month since 1 year earlier. Each episode continued for 3–5 hours and disappeared spontaneously. The abdominal wall was soft and flat, and there was tenderness in the lower abdomen. Contrast-enhanced abdominal CT imaging revealed a whirl sign of the mesenteric artery and caliber change of the terminal ileum. A high-density mass with helical strands of the omentum was identified retrospectively. An emergency operation was performed under a provisional diagnosis of ileal volvulus. During diagnostic laparoscopy, omental torsion due to adhesion to the ileum was observed, whereas the ileal volvulus was released spontaneously. Neither ileum nor omentum showed necrosis. Resection of adhesion was performed. It was considered that recurrent ileal volvulus gradually caused the omental torsion.
