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Two Cases of Primary Segmental Infarction of the Greater Omentum

Journal of the Korean Pediatric Society 2001;44(6):694-699.
Published online June 15, 2001.
Two Cases of Primary Segmental Infarction of the Greater Omentum
Do Yeon Kim1, Weon Park1, Dong Jin Lee1, Jung Hyeok Kwon2
1Departments of Pediatrics, Ulsan Dong-Kang General Hospital, Ulsan, Korea
2Departments of Radiology, Ulsan Dong-Kang General Hospital, Ulsan, Korea
대망(Greater Omentum)의 일차성 분절성 경색 2례
김도연1, 박원1, 이동진1, 권중혁2
1울산동강병원 소아과
2울산동강병원 방사선과
Abstract
Primary segmental infarction of the greater omentum is a rare condition which usually simulates acute appendicitis or cholesystitis because of right-sided abdominal pain, tenderness, fever and leukocytosis. Its cause is unknown. Most authors believe that the condition results from an embryologic variant associated with anomalous and fragile blood supply of the right lower portion of the greater omentum, which is consequently susceptible to infarction. Because there are no characteristic clinical findings, a correct preoperative diagnosis is rare. But cross-sectional imaging by ultrasound(US) or computed tomography(CT) will demonstrate characteristic findings in a location corresponding to the patient's point of maximal tenderness. These findings consist of an ovoid or cake-like mass in the omental fat with surrounding inflammatory changes. Surgical resection of the infarcted omentum is the usual treatment when the diagnosis is not established preoperatively. If the diagnosis can be established preoperatively with cross-sectional imaging, then these patients can be managed conservatively, and laparotomy can be avoided. We report two cases of primary segmental infarction of the greater omentum. One patient underwent surgery, and the diagnosis was confirmed histologically. The other patient was treated conservatively after the diagnosis was established with clinical, US and CT findings, which were similar and consistent with the previous patient.
Key Words: Primary segmental infarction, Greater omentum, Cross-sectional imaging, Conservative treatment


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