Skip to main content

Omental infarct: CT imaging features

An Erratum to this article was published on 24 February 2011

Abstract

Background

The aim of this study is to describe contrast-enhanced computed tomographic (CT) features of acute omental infarction and to study the evolutionary changes on follow-up CT imaging.

Methods

Fifteen cases of omental infarction were evaluated for their initial CT imaging features. The imaging features evaluated included size of the fatty lesion, location, peripheral rim, and relation to colon. CT findings were correlated with etiology, clinical presentation, and leukocytosis. Follow-up CT images were available in eight patients and the imaging features were studied.

Results

Eight omental infarcts were of unknown etiology and seven were secondary to abdominal surgery. In 53% of patients (eight of 15), the location of the omental infarct was in the right lower, mid, or upper quadrants. These eight right-side infarcts occurred in six patients with primary omental infarcts. In 13 of 14 patients who underwent CT within 15 days of onset of omental infarct, the margin of the lesion was ill defined. Primary omental (n = 8) infarcts were seen in younger patients (p = 0.02) and were larger on CT (p = 0.02) compared with secondary omental infarcts. CT findings evolved from an ill-defined, heterogeneous fat-density lesion to a well-defined, heterogeneous fat-density lesion with a peripheral hyperdense rim in all six secondary omental infarctions for which acute stage and follow-up CT images were available for interpretation.

Conclusion

There is a significant difference in the age distribution and CT findings in terms of size of the omental infarction between primary and secondary etiologies. On follow-up CT, secondary omental infarcts progressively shrank and developed a well-defined, hyperdense rim around a fatty core.

This is a preview of subscription content, access via your institution.

Figure 1
Figure 2
Figure 3

References

  1. Puylaert JB, (1992) Right-sided segmental infarction of the omentum: clinical, US, and CT findings. Radiology 185:169–172

    PubMed  CAS  Google Scholar 

  2. Miguel Perello J, Aguayo Albasini JL, Soria Aledo V, et al. (2002) Omental torsion: imaging techniques can prevent unnecessary surgical interventions. Gastroenterol Hepatol 25:493–496

    PubMed  CAS  Google Scholar 

  3. van Breda Vriesman AC, Lohle PN, Coerkamp EG, Puylaert JB (1999) Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history. Eur Radiol 9:1886–1892

    PubMed  Article  Google Scholar 

  4. Bush P (1896) A case of hemorrhage into the greater omentum. Lancet 1:286

    Article  Google Scholar 

  5. Singh AK, Gervais DA, Hahn PF, et al. (2004) CT appearance of acute appendagitis. AJR 183:1303–1307

    PubMed  Google Scholar 

  6. Singh AK, Alhilali LM, Gervais DA, Mueller PR (2004) Omental infarct: an unusual CT appearance after superior mesenteric artery occlusion. Emerg Radiol 10:276–278

    PubMed  Article  Google Scholar 

  7. Phillips RW, Peterson CM (1988) Infarction of the omentum after cesarean section. A case report. J Reprod Med 33:382–384

    PubMed  CAS  Google Scholar 

  8. Schwartzman GJ, Jacobs JE, Birnbaum BA (2001) Omental infarction as a delayed complication of abdominal surgery. Clin Imaging 25:341–343

    PubMed  Article  CAS  Google Scholar 

  9. Hollerweger A, Rettenbacher T, Macheiner P, Gritzmann N (1996) Spontaneous fatty tissue necrosis of the omentum majus and epiploic appendices: clinical, ultrasonic and CT findings. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb 165:529–534

    Article  CAS  Google Scholar 

  10. Garant M, Taourel P, Fried GM, Bret PM (1995) Thickening of the transverse colon associated with torsion of the greater omentum. AJR 165:1309

    PubMed  CAS  Google Scholar 

  11. Helmrath MA, Dorfman SR, Minifee PK, et al. (2001) Right lower quadrant pain in children caused by omental infarction. Am J Surg 182:729–732

    PubMed  Article  CAS  Google Scholar 

  12. Kimber CP, Westmore P, Hutson JM, Kelly JH (1996) Primary omental torsion in children. J Paediatr Child Health 32:22–24

    PubMed  Article  CAS  Google Scholar 

  13. Vertuno LL, Dan JR, Wood W (1980) Segmental infarction of the omentum: a cause of the semi-acute abdomen. Am J Gastroenterol 74:443–446

    PubMed  CAS  Google Scholar 

  14. Balthazar EJ, Lefkowitz RA (1993) Left-sided omental infarction with associated omental abscess: CT diagnosis. J Comput Assist Tomogr 17:279–381

    Google Scholar 

  15. Patchell RD (1977) A fatal case of idiopathic omental infarction. W Va Med J 73:29–30

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. K. Singh.

Additional information

An erratum to this article can be found online at http://dx.doi.org/10.1007/s00261-011-9711-3

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Singh, A.K., Gervais, D.A., Lee, P. et al. Omental infarct: CT imaging features. Abdom Imaging 31, 549–554 (2006). https://doi.org/10.1007/s00261-005-0251-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-005-0251-6

Keywords

  • Omental infarction
  • Omentum
  • Computed tomography
  • Acute abdomen