F. Goti et al., Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: Report of case, SURG TODAY, 30(5), 2000, pp. 451-453
Idiopathic or spontaneous segmental infarction of the greater omentum (ISIG
O) is a rare cause of acute right-sided abdominal pain. The symptoms simula
te acute appendicitis in 66% of cases and cholecystitis in 22%. Progressive
peritonitis usually dictates laparotomy, and an accurate diagnosis is rare
ly made before surgery. The etiology of the hemorrhagic necrosis is unknown
, but predisposing factors such as anatomic variations in the blood supply
to the right free omental end, obesity, trauma, overeating, coughing, and a
sudden change in position may play a role in the pathogenesis, We present
herein the case of a 37-year-old man in whom ISIGO, precipitated by obesity
and overeating, was successfully diagnosed and treated by laparoscopy, Res
ection of the necrotic part of the greater omentum is the therapy of choice
, and ensures fast recovery and pain control. Serohemorrhagic ascites is a
common finding in ISIGO, and careful exploration of the whole abdominal cav
ity should be performed. The laparoscopic approach allows both exploration
and surgical intervention.