Torsion of the greater omentum

Abstract

The medical records of the patients hospitalized in the surgical department and urgently operated for an acute abdominal greater omentum torsion over the past 10 years were retrospectively analyzed. Only two cases that was happened over the past three years and was not related were detected. Both young patients were delivered urgently to the hospital on‑duty surgical department of the city with a clinic of acute abdominal surgical pathology. Both patients underwent the full range of necessary laboratory and instrumental examinations. Patients were repeatedly examined by the on‑duty team consisting of three surgeons with significantly experience. The similarity with the clinical picture of acute appendicitis determined next treatment tactics. The type‑specificity of these patients was determined by the fuzziness of appendicular symptoms during physical examination. The increase in some manifestations of clinical symptoms led to the preliminary diagnosis of acute appendicitis. Both patients were operated on urgently after preoperative preparation. In the operating room, with a thorough revision, the secondary torsion of the greater omentum is visualized. Photofixation and measurement of the resected sections of the omentum were taken. Surgical experience, physical and additional examination methods do not provide clear reliable information about the presence of torsion of the greater omentum. Ultrasound examination of torsion of the greater omentum makes it possible only to determine the «thickened appendix» or infiltration in the abdominal cavity, but it is difficult to determine its components and genesis. When the torsion of the greater omentum is determined, a revision of the abdominal organs should be carried out to exclude the surgical pathology of the appendix, small intestine, cecum and pelvic organs.