A Case of Idiopathic Omental Torsion with Trans-Epiploic Hernia

Atsushi Kudo, Tuneo Kawasaki, Masatoshi Jibiki, Seitaku Hayashi, Toukichi Gen, Eiichi Yabata, Masanori Kikuchi^*, Kenichi Teramoto^**, Shigeki Arii^** and Takehisa Iwai^**

Department of Surgery and Pathology^*, Toride Kyoudou Hospital, Department of Surgery, Tokyo Medical and Dental University^**

Idiopathic torsion of the omentum is relatively rare, with only 59cases reported in the Japanese literature. We treated a very rare idiopatic torsion of the omentum with transepiploic hernia in a 27-year-old man who was seen for lower abdominal pain. He had tenderness with Blumberg sign in the left lower abdomen. Computed tomography (CT) showed a large fat density mass with concentric linear strands in the right lower abdomen. Laparotomy under a diagnosis of omental tumor, revealed a dark-red omental mass with triple clock-wise torsion and bloody ascites. The omentum contained many interstices and circulatory disturbance of the intestine was observed due to omental torsion. The necrotic omentum, including interstices, was resected. Although preoperative diagnosis of this disease is usually difficult, comfirmative diagnosis is possible when CT shows concentric linear strands.

Key words
idiopatic torsion of the omentum, transepiploic hernia, large fat density mass with concentric linear strands

Reprint requests
Atsushi Kudo Department of Surgery, Tokyo Medical and Dental University 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 JAPAN

Accepted
July 31, 2001

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