Omental infarction

Case contributed by Michael P Hartung

Presentation

Right lower chest pain.

Patient Data

Age: 70
Gender: Male
ct

There is haziness/stranding of the omentum along the anterior/cranial aspect of the ascending colon near the hepatic flexure, measuring 3.6 x 1.7 x 2.7 cm. No corresponding inflamed diverticulum is present. A small linear structure can be followed from the hepatic flexure into this structure, suggesting a thrombosed vessel (easiest to follow on the coronal images). 

Case Discussion

Originally imaged with CT PA study for chest pain, haziness in the RUQ fat was noticed and delayed images of the abdomen and pelvis were performed. 

This is a typical location for an omental infarct, which most commonly occurs in the right abdomen, as opposed to epiploic appendagitis, which is more typical in the sigmoid colon. There is an association with obesity, strenuous activity, congestive heart failure, and surgery or trauma.

Omental infarction is managed conservatively.

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