An isolated abscess of the omentum malus - an uncommon complication of Wegener's granulomatosis

Wegener's granulomatosis is a systemic vasculitic syndrome of unknown aetio logy it can involve virtually any organ and often a multitude of organ-tiss ues. The manifestation in many uncommon anatomical sites of involvement may be distinctive or atypical An unusual presentation of Wegener's granulomat osis is described in a 58-year-old man (with acute abdominal pain without s igns of peritonitis or distension) necessitating immediate surgical interve ntion. Prior to the onset of abdominal symptoms immunosuppressive therapy w as administered for 3 years after diagnosis of the specific disease. The su rgical findings have shown an isolated abscess in the omentum majus. Subseq uent histological examination of the operation specimens of omentum majus r evealed a necrotizing inflammatory process which was favourably initiated b y vasculitis activity of Wegener's granulomatosis. An abscess in the omentu m majus in Wegener's granulomatosis has not been reported previously Obviou sly may acute abdominal pain be a clinical manifestation of the histologic omentum-majus-vasculitis; observed ii, Wegener's granulomatosis. This case demonstrates that this presentation of Wegener's granuiomatosis may mimic m uch more common abdominal diseases like intestinal perforation or haemorrha ge.