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Diagnosis and Management of Adult Omental Infarction: 10-Year Case Series

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Abstract

Background

Omental infarction is a rare cause of an acute abdomen with nonspecific signs that can be easily mistaken with other more common intra-abdominal pathologies. The increased use of radiological imaging has brought this diagnosis to attention with respect to management plan. We present the experience of an Australian hospital network with the diagnosis and management of omental infarction to raise awareness of this uncommon pathology.

Methods

A retrospective review of medical records of adult patients diagnosed with omental infarction from 2010 to 2020 was conducted across four major hospitals in South Western Sydney. Data relating to clinical presentation, investigations, management and outcomes were obtained.

Results

Omental infarction was diagnosed in 61 patients (mean 51.1 years, range: 19–76 years old). All patients presented with nonspecific abdominal pain with the most common sites being the right iliac fossa followed by the right upper quadrant, respectively, over an average period of 2.7 days. Computed tomography and/or diagnostic laparoscopy identified omental infarction in all cases. Forty-two patients (68.9%) had successful conservative management, six failed conservative management and 19 patients had emergency laparoscopic omentectomy. The average hospital length of stay was 3.4 days with no significant morbidity or mortality.

Conclusion

Omental infarction generally presents with nonspecific clinical signs often masquerading as other more common abdominal diagnosis like cholecystitis or appendicitis. A trial of conservative management initially coupled with appropriate imaging should be recommended within the first 24–48 h before considering surgical treatment in refractory cases.

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Acknowledgements

We would like to extend our acknowledgement to the general surgical team members at Bankstown-Lidcombe Hospital and the medical administration who assisted across the units in the collection of the data.

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Authors and Affiliations

  1. Bankstown-Lidcombe Hospital, Eldridge Rd, Bankstown, NSW, 2200, Australia

    Jason Diab, Sarit Badiani & Christophe R. Berney

  2. School of Medicine, University of Sydney, Sydney, Australia

    Jason Diab

  3. School of Medicine, University of Notre Dame, Sydney, Australia

    Jason Diab

  4. School of Medicine, University of New South Wales, Sydney, Australia

    Sarit Badiani & Christophe R. Berney

Authors
  1. Jason Diab
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  2. Sarit Badiani
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  3. Christophe R. Berney
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Contributions

The authors contributed to the conception and design of the manuscript, revised it critically for important intellectual content, approved the final version to be published and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jason Diab.

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No authors have any competing interests.

Human and animal rights

This project has been approved by the Human Research Ethics Committee with no restrictions. There is no source of financial or other support and no financial or professional relationships which may pose a competing interest. Patient consent has been obtained. The data are deemed confidential and under ethics cannot be disseminated openly due to confidentiality and privacy.

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Diab, J., Badiani, S. & Berney, C.R. Diagnosis and Management of Adult Omental Infarction: 10-Year Case Series. World J Surg 45, 1734–1741 (2021). https://doi.org/10.1007/s00268-021-06043-1

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  • DOI: https://doi.org/10.1007/s00268-021-06043-1

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