Abstract
Primary torsion of the omentum presenting with acute abdomen is a relatively rate entity. There are only 33 cases which had no organic disease in the Japanese literature. This paper describes such a case of primary torsion of the greater omentum.
A 54-year-old female was admitted to the hospital because of a severe abdominal pain localized in the right upper quadrant. On physical examination, tenderness and muscle defense were noted in the region of right hypochondrium. She had high fever and leukocytosis. An emergency operation was performed under a diagnosis of suspicion of perforative peritonitis. At laparotomy, a 5.6×3.8×2.5cm dark-red omental mass was found associated with a few bloody ascites. It was a part of the greater omentum and infarcted by torsion (2.5 times in a clockwise rotation). The affected omentum including normal surround-ing tissue was resected. Histological findings showed necrotic change of the omentum with hemorrhage and mild inflammatory cells infiltration. The postoperative course was uneventful.
Thirty four cases including our case in the Japanese literature are reviewed.
