Abstract
Torsion of omentum is a relatively rare disease, and 70 cases have been reported in Japan up to now. We report on a case of torsion of omentum accompanied by incarcerated right lateral inguinal hernia, which developed at a swing in golf by ill chance, together with a review of these 71 cases.
A 54-year-old man was seen in our hospital complaining of right lower abdominal pain. From clinical findings, partial incarceration in the intestine or abscess formation due to perforation of appendix was suspected. Laparotomy was carried out. Laparotomy findings revealed the greater omentum to form a fist-sized lump besides hemorrhagic serous ascites; the tip of the lump tapered and incarcerated to the right medial inguinal ring; and its central-side, being slender, was twisted counterclockwise by 3 turns. No abnormalities were noted in the appendix vermiformis. The greater omentum was resected at a normal site, repair of hernia and appendectomy being performed.
Documented cases in this country comprised 45 cases of secondary (63%), 21 of idiopathic (30%), and 5 of unknown (7%). It was in only one case that definite diagnosis could be made preoperatively. Forty-nine cases (69%) were diagnosed as appendicitis preoperatively. Extirpation of the strangulated greater omentum is the recommendatory treatment offering a favorable prognosis.
