A Case of Primary Idiopathic Torsion of the Greater Omentum

Masafumi Kataoka, Kensuke Tsunemitsu, Masashi Miyazaki, Takashi Katayama

Department of Surgery, Saiseikai Saijo Hospital

A case of primary idiopathic torsion of the greater omentum is reported. A 57-year-old man came to our hospital complaining of severe abdominal pain. The pain was located in the right lower quadrant and slight fever with leukocytosis was observed. Under the diagnosis of acute appendicitis an operation was performed, and the appendix was found to be not very inflamed. After further examination of the peritoneal cavity, the greater omentum was found to be twisted five times in a clock-wise direction. Ischemia of the omentum was not improved after correction of the torsion. So it was resected at 2 cm proximal to the twisting point. Histological findings showed ischemic changes, that is a slight inflammatory change and considerable hemorrhagic change. Only 22 cases of primary idiopathic torsion of the omentum have been reported in Japan. Though it is verydifficult to make an exact diagnosis preoperatively, torsion of the omentum should be considered when a discrepancy between severe abdominal pain and inflammatory signs is observed.

Key words
primary idiopathic torsion of the greater omentum

Reprint requests
Masafumi Kataoka First Department of Surgery, Okayama University, School of Medicine
2-5-1 Shikata-cho, Okayama, 700 JAPAN

Accepted
November 20, 1991

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