Omental infarction

Case contributed by Dr Jeremy Jones

Presentation

Generalized abdominal pain following surgery over a period of weeks.

Patient Data

Age: 55 years
CT

More extensive omental change in the left-paramedian anterior abdomen. Adjacent subcutaneous edema.

CT

Further enlargement of the left omental focal abnormality. Central gas. Peripheral edema.

Case Discussion

This patient underwent a laparoscopic antrectomy with Roux-en-Y formation for drug-resistant GERD.

He complained of generalized abdominal pain in the days and weeks following surgery.

Deep to the left abdominal port site at the level of the umbilicus is an abnormal area of omentum. With time, there is maturation of this area of abnormality with a heterogeneous appearance. 

Features of those of developing omental infarction, which is usually treated conservatively. The differential diagnosis in this case would be developing infection.

The surgical team decided to adopt a position of watchful waiting and his inflammatory markers decreased and symptoms resolved.

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