Multidetector Computed Tomography Evaluation of Omental Infarct

Abstract

Abstract Background Omental infarction is a rare cause of acute pain abdomen and is difficult to diagnose clinically due to nonspecific clinical features. Multidetector computed tomography (MDCT) imaging of the abdomen is essential for the diagnosis of omental infarction and is also crucial to rule out appendicitis and other causes of acute pain abdomen. Objective The main purpose of this article is to describe the MDCT features of omental infarction in clinching the diagnosis and differentiating it from its clinical mimics. Methods CT findings of five patients with diagnosed omental infarction were retrospectively reviewed from 2014 to 2019. All patients presented with pain abdomen on the right side of the abdomen with various clinical diagnoses. MDCT was done for diagnosis and features evaluated include size of the lesion, location, relation to colon, and findings that were correlated to clinical presentation and etiology. Results Age distribution ranged between 36 and 55 years with female predominance. Out of five cases, one was secondary omental infarction due to inguinal hernia causing omental torsion and the other four cases were of unknown etiology. Three cases were managed conservatively and the other two cases were surgically managed. Three lesions were in right iliac fossa and two lesions were in the supraumbilical region on the right side. Conclusion Omental infarction should be considered important in the differential diagnosis of acute pain abdomen mimicking acute appendicitis and requires CT abdomen to establish diagnosis. Knowledge of typical imaging findings and application for diagnosis are important, as it is a self-limiting disease and can avoid unnecessary surgical interventions.