Torsion of the omentum – an unexpected cause of acute surgical abdomen in a pregnant woman –case report

Česká verzia

Authors: M. Novotná; R. Müller
Authors place of work: Gynekologicko-porodnické oddělení Masarykovy městské nemocnice, Jilemnice, primář MUDr. Z. Vocásek
Published in the journal: Ceska Gynekol 2015; 80(3): 210-213

Summary

Objective:
Torsion of the omentum is a rare cause of acute surgical abdomen. Here we describe a case of a pregnant woman with acute abdominal pain and a perioperative diagnosis of necrosis of torted omentum was made.

Design:
Case report.

Setting:
Department of Obstetrics and Gynaecology, Masaryk’s Hospital, Jilemnice.

Case report:
Thirty year old female patient, who was 38 weeks pregnant, presented to our department with acute surgical abdomen. Acute appendicitis was suspected and an urgent caesarean section followed by appendectomy was scheduled. However, perioperatively a necrotic part of torted omentum was identified and resected.

Conclusion:
Torsion of the omentum is a rare cause of acute abdominal pain which is usually diagnosed only perioperatively. This condition usually presents with nonspecific symptoms and most commonly mimics acute appendicitis. Owing to, inexplicit symptoms and wide range of differential diagnoses it is important to think of this entity as a possible cause of acute abdominal pain. Clear indication for abdominal surgery, especially in pregnant patients is essential and requires efficient team working between gynaecologists, abdominal surgeons and radiologists.

Keywords:
torsion of the omentum, acute surgical abdomen, pregnancy

Zdroje

1. Al Tokhais, TI., Bokhari, AA., Noureldin, OH. Primary omental torsion: a rare cause of acute abdomen. Saudi J Gastroenerol, 2007, 13(3), p. 144–146.

2. Andreuccetii, J., Ceribelli, C., Manto, O., Chiaretti, M., et al. Primary omental torsion (POT): a review of literature and case report. World J Emerg Surg, 2011, 26, 6, p. 6.

3. Borgaonkar, V., Deshpande, S., Rathod, M., Khran, I. Primary omental torsion is a diagnostic challenge in acute abdomen – a case report and literature review. Indian J Surg, 2013, 75(4), p. 255–257.

4. Čihák, R. Anatomie 2, druhé, upravené a doplněné vydání. Praha: Grada Publishing, 2002, s. 71.

5. Eitel, GG. Rare omental torsion. N Y Med Rec, 1899, 55, p. 715–716.

6. Hájek, Z., et al. Rizikové a patologické těhotenství. Praha: Grada Publishing, 2004, s. 128.

7. Hasala, P. Torze omenta – neobvyklá příčina náhlé příhody břišní. Rozhl Chir, 2010, 89(11), s. 670–671.

8. Itinteang, T., van Gelderen, WF., Irwin, RJ. Omental whirl: Torsion of greater omentum. ANZ J Surg, 2004, 74, p. 702–703.

9. Jeganathan, R., Epanomeritakis, E., Diamond, T. Primary torsion of omentum. Ulster Med J, 2002, 71(1), p. 76–77.

10. Karayiannakis, AJ., Polychronidis, A., Chatzigianni, E., et al. Primary torsion of the greater omentum: report of the case. Surgy Today, 2002, 32(10), p. 913–915.

11. Kimber, CP., Westmore, P., Hutson, JM., et al. Primary omental torsion in children. J Paediatr Child Health, 1996, 32(1), p. 22–24.

12. Khan, FA., Liaqat, N., Dar, SH., Sandhu, AI., et al. Two cases of omental torsion mimicking acute apendicitis. APSP J Case Rep. 2014, 1,5(1):8. eCollection 2014 Jan.

13. Leitner, MJ., Jordán, CG., Spinner, MH., Reese, EC. Torsion, infarction and hemorrhage of the omentum as a cause of acute abdominal distress. Ann Surg, 1952, 135(1), p. 103–110.

14. Poujade, O., Ghiles, E., Senasli, A. Primary torsion of the greater omentum: case report – review of literature: diagnosis cannot always be performed before surgery. Surg Laparosc Endosc Percutan Tech, 2007, 17(1), p. 54–55.

15. Rousková, L. Torze omenta v graviditě. Gynekolog. 2004, 13(4), s. 163.

16. Scabini, S., Rimini, E., Massobrio, A., et al. Primary omental torsion: A case report. World J Gastrointest Surg, 2011, 27, 3(10), s. 153–155.

17. Theriot, JA., Sayat, J., Franco, S., Buchino, JJ. Childhood obesity: a risk factor for omental torsion. Pediatrics, 2003, 112(6 Pt 1), e460.

18. Vokurka, M., Hugo, J., a kol. Velký lékařský slovník, 4. vyd. Praha: Jessenius, Maxdorf, 2004, s. 582.