A CASE OF OMENTAL PANNICULITIS IN WHICH ECHOGRAPHIC CHANGES FACILITATED DIAGNOSIS

Abstract

A 56-year-old man admitted for right upper quadrant pain and loss of appetite was found in palpation to have a mass with tenderness in the right upper quadrant. Laboratory tests showed a white cell count of 13, 000/μl and CRP of 18.4mg/dl. Abdominal echography showed an abscess-like hypoechoic mass 3.2×2.4cm in diameter and a strong posterior echo. After treatment non per os and with antibiotics, clinical symptoms improved and the echo finding changed from a fluid lesion to a solid tumor. For several weeks, the tumor remained in the same size, necessitating surgery because malignancy could not be ruled out. The tumor, together with the partial ileum, partial transverse colon, and partial abdominal wall, were resected due to tumor adhesion to these organs. Histological examination showed omental panniculitis. In Japan. 14 cases of omental panniculitis, including ours, have been reported. Preoperative diagnosis was very difficult, necessitating resection due to possible acute abdomen or malignancy. The change in echography findings was useful in differentiation from a malignant tumor.