Omental infarction

Preoperative diagnosis and laparoscopic management in children

Ankush Gosain, Martin Blakely, Thomas Boulden, John K. Uffman, Rupa Seetharamaiah, Eunice Huang, Max Langham, James Eubanks

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Omental infarction (OI) is an unusual, poorly characterized cause of abdominal pain in children and is often mistaken for appendicitis preoperatively. We present our experience with this disease process over a 5-year period to identify preoperative factors to aid in timely diagnosis and treatment. Methods: We retrospectively reviewed the medical records of all children that had OI and underwent laparoscopic omentectomy from November 2004 to June 2009. Results: Ten patients with the diagnosis of OI were identified. OI occurred in 9 boys and 1 girl, with a median age at presentation of 8.5 years (range, 7-11). Median body mass index at presentation was 23.7 (range, 17-29), with 1 child categorized as healthy weight for age, 1 child as overweight for age, and 5 children as obese for age, based on Centers for Disease Control and Prevention criteria. All patients complained of right-sided abdominal pain; 4 patients complained of predominantly right-upper quadrant (RUQ) pain, 3 patients of right-lower quadrant (RLQ) pain, and 3 of combined RUQ/RLQ pain. On examination, 6 patients had RUQ tenderness and 4 patients had RLQ tenderness. The median duration of symptoms prior to seeking medical attention was 3 days (range, 2-7). All patients underwent computed tomography and the preoperative diagnosis of OI was established in 9 of 10 cases. Operative time was 48±14 minutes. All patients underwent resection of the infarcted omentum; 2 patients underwent concurrent appendectomy. Median length of stay was 2 days (range, 2-4). Conclusions: OI occurs predominantly, but not exclusively, in obese preadolescent males. OI can be reliably distinguished from appendicitis on preoperative history, physical examination, laboratory analysis, and imaging. Laparoscopic omentectomy results in prompt resolution of symptoms and discharge.

Original languageEnglish (US)
Pages (from-to)777-780
Number of pages4
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume20
Issue number9
DOIs
StatePublished - Nov 1 2010

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Infarction
Patient Rights
Appendicitis
Pain
Abdominal Pain
Omentum
Appendectomy
Centers for Disease Control and Prevention (U.S.)
Operative Time
Physical Examination
Medical Records
Length of Stay
Body Mass Index
History
Tomography
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Omental infarction : Preoperative diagnosis and laparoscopic management in children. / Gosain, Ankush; Blakely, Martin; Boulden, Thomas; Uffman, John K.; Seetharamaiah, Rupa; Huang, Eunice; Langham, Max; Eubanks, James.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques, Vol. 20, No. 9, 01.11.2010, p. 777-780.

Research output: Contribution to journalArticle

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