Sonographic appearance of omental infarction in children

Background. Omental infarction has been previously reported in the adult su rgical and imaging literature; however, the imaging features of this entity in children have received little attention. Objective. The purpose of our study was to identify the sonographic feature s of omental infarction in nine children who had preoperative sonography an d surgically proven omental infarction. Materials and methods. Sonographic images were reviewed and correlated with clinical information obtained from the patients' medical records, includin g clinical presentation, operative notes, and pathology reports. Results. In seven of the children, sonography demonstrated a focal area of moderately increased echogenicity in the omental fat in the right abdomen ( a previously described finding in omental infarction). This was an isolated finding in four of these cases. In the three cases where this was not an i solated finding, the more complex sonographic appearance led to incorrect p reoperative imaging diagnoses. This finding of increased echogenicity in th e omental fat was not present in the two remaining patients. Conclusion. Our study confirms that foci of moderately increased echogenici ty in the omentum of the right abdomen, a sonographic finding described in omental infarction in a large series in adults (and in a single prior case report in children), can be seen in children as well. However, although thi s is a relatively unique finding, it may be absent in some cases or may be seen in conjunction with other sonographic findings which may preclude the correct preoperative sonographic diagnosis.