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Not only fat: omental infarction and its mimics in children. Clinical and ultrasound findings: a pictorial review

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Abstract

Acute abdominal pain in children is the most common cause of emergency department admissions. Omental infarction is a rare cause of acute abdominal pain in this age group, accounting for approximately 15% of cases in children and 0.024–0.1% of cases of surgery for suspected appendicitis at the same age. Its clinical presentation may mimic similar diseases such as acute appendicitis, epiploic appendagitis, and mesenteric panniculitis. Ultrasound is the modality of choice for the initial evaluation of acute abdominal pain in pediatric patients and it can be used with confidence in the diagnosis and management of omental infarction in children. In this brief review, we focus on the main ultrasound findings and their diagnostic clue for omental infarction and its mimics.

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Acknowledgements

The authors would especially like to thank Dr. Ludovica Esposito for the English language editing. The authors also thank dr. Aurelio Porreca, Emergency Surgery Department “Santobono-Pausilipon” Children Hospital—Naples, IT for providing the Figs. 3 and 9.

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Author notes

  1. Francesco Esposito, Marco Di Serafino and Angela Mauro contributed equally to this work.

Authors and Affiliations

  1. Department of Emergency Radiology, “Santobono-Pausilipon” Children’s Hospital, Naples, Italy

    Francesco Esposito & Dolores Ferrara

  2. Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, Antonio Cardarelli st 9, 80131, Naples, Italy

    Marco Di Serafino & Francesca Iacobellis

  3. Department of Pediatric Emergency, “Santobono-Pausilipon” Children’s Hospital, Naples, Italy

    Angela Mauro & Letizia Zenzeri

  4. Department of Pediatric 2nd Unit, “Santobono-Pausilipon” Children’s Hospital, Naples, Italy

    Carmela Mercogliano

  5. Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, “Sapienza” University of Rome, “Sant’Andrea” University Hospital, Rome, Italy

    Chiara Cocco, Melania Evangelisti, Chiara Ziparo & Giovanni Di Nardo

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  1. Francesco Esposito
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Correspondence to Marco Di Serafino.

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Video 1. Omental infarction “tethered fat sign”: On the left, the omental infarction tethered to the abdominal wall; on the right, the normal mobile omental fat (MP4 8237 kb)

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Esposito, F., Di Serafino, M., Mauro, A. et al. Not only fat: omental infarction and its mimics in children. Clinical and ultrasound findings: a pictorial review. J Ultrasound 23, 621–629 (2020). https://doi.org/10.1007/s40477-020-00492-5

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