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Idiopathic Segmental Infarction of Omentum; Surgeon’s Perspective in Comparison with Conservative Line of Management

Dinesh Babu M.V., Assistant Professor, Department of General Surgery, PK Das Institute Of Medical Sciences, Vaniamkulam Palaghat – 679522, Kerala. , Dinesh Babu M.V.a , Reghu Sankarb , Lokesh C.c

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New Indian Journal of Surgery 8(3):p 440-444, Jul-Sep 2017. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8317.27

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Abstract

Segmental infarction of omentum was first described by Bush in 1896.Incidence is <.1% of laparotomies done for the a/c abdominal cases [5] .Incidence is more in males (2:1). Exact aetiology is not known so we take it as idiopathic. There are different postulates for its occurrence. One is fragile blood vessels of right lower segment of omentum and another is embryological maldevelopment of right sided omental blood supply [5]. It has also been described that it occurs after exertion, after heavy meal and in obese patients. Clinicallyit may present as a/ c appendicitis, diverticulitis or cholecystitis. CT scan abdomen will help to diagnose thiscondition [3]. There are different schools of thought. One is conservative line of management and other is surgical line of management. There are pros and cons of both management. Here we discuss 6 patients who presented in our institute with abdominal pain and were managed by both surgically (Laparoscopic resection) and conservatively. After surgery patients were asymptomatic after 1 week except minimal tenderness over port sites, whereas patients managed conservatively had to take analgesics for 4-6 weeks.We found early resolution of symptoms in surgically managed patients in comparison to conservatively managed patients.

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8317.27

Keywords

Omental Infarction; Omentum; a/c Abdomen; Laparoscopy; Resection of Omentum;RIF pain; RHC Pain. 

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