Presentation
The patient complained of lower abdominal pain for 3 days as well as right iliac fossa tenderness.
Patient Data
Focal ovoid-shaped localized omental fatty stranding is located at the right lower abdominal quadrant, the para-midline region just posterior to the lower rectus muscle portion. It lies anterior to the redundant sigmoid colon, measuring about 4.2 cm, with a visualized relative hyperdense vascular structure within. It is consistent with a picture of focal omental infarction. The adjacent sigmoid colon is of normal wall thickness and enhancement. The appendix looks retro-cecal, normal in diameter, and air-filled.
Case Discussion
Imaging differential considerations include:
acute appendicitis, if right-sided
omental neoplasms,e.g.,. exophytic angiomyolipoma, atypical liposarcoma
omental infarction occurs close to the ascending colon and is typically larger than 3 cm
The described CT features are consistent with omental infarction. The appendix was normal in CT appearance. The patient managed conservatively and successfully.
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