Access to the PDF text
Service d'aide à la décision clinique

Free Article !

La Presse Médicale
Volume 45, n° 10
pages 824-828 (octobre 2016)
Doi : 10.1016/j.lpm.2016.06.006
Omental ischemia
L’ischémie du grand épiploon

Jenny Tannoury 1, Cesar Yaghi 1, Joseph Gharios 2, Bassam Abboud 2,
1 Faculty of Medicine, Saint-Joseph University, Hôtel Dieu de France Hospital, Department of Gastroenterology and Hepatology, Beirut, Lebanon 
2 Faculty of Medicine, Saint-Joseph University, Hôtel Dieu de France Hospital, Department of General Surgery, Beirut, Lebanon 

Bassam Abboud, Hôtel Dieu de France Hospital, Department of General Surgery, Alfred Naccache Street, 16-6830 Beirut, Lebanon.

Omental ischemia is a rare cause of acute abdomen. Clinical diagnosis is usually difficult because clinical signs and symptoms are similar to other common causes of abdominal pain. The most common differential diagnosis is acute appendicitis. Diagnosis is mainly based on ultrasound, and especially computed tomography scan analysis. There is, at present, no standard treatment modality for omental ischemia. When diagnosed by radiological imaging, omental ischemia can be managed conservatively. We hereby review incidence, etiology, pathology, clinical presentation, differential diagnosis, biological anomalies, radiological features, and treatment options of omental ischemia.

The full text of this article is available in PDF format.

L’ischémie du grand épiploon est une cause rare d’abdomen aigu. Le diagnostic clinique est souvent difficile car les signes cliniques et les symptômes sont semblables à d’autres causes fréquentes de douleurs abdominales. Le diagnostic différentiel le plus commun est une appendicite aiguë. Le diagnostic repose principalement sur l’échographie et le scanner. À l’heure actuelle, aucun traitement standard existe pour l’ischémie épiploïque. Lorsqu’elle est diagnostiquée par l’imagerie, l’ischémie épiploïque peut être gérée de manière conservatrice. Nous discutons dans ce papier l’incidence, l’étiologie, la pathologie, la présentation clinique, le diagnostic différentiel, les anomalies biologiques, radiologiques, et les options de traitement de l’ischémie épiploïque.

The full text of this article is available in PDF format.

Omental ischemia is a rare cause of acute abdomen; diagnosis is usually difficult because clinical symptoms and signs are similar to other common causes of abdominal pain. It mainly affects adults, with men being involved twice as frequently as women, with the majority being overweight [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. It is quite difficult to establish a preoperative diagnosis of the condition, but with wide use of computed tomography (CT) in patients with acute abdominal pain, this rare disease may be accurately diagnosed before surgery [12, 13, 14, 15]. The most common differential diagnosis is acute appendicitis [16, 17]. Diagnosis of omental ischemia is mainly based on ultrasound (US) and especially CT scan analysis. There is, at present, no standard treatment modality. Two options are predominant: conservative medical treatment and early laparoscopic surgical intervention [5, 12, 13, 14, 15]. We hereby review incidence, etiology, pathology, clinical presentation, differential diagnosis, biological anomalies, radiological features, and treatment options of omental ischemia.

Incidence and etiology

The accurate incidence of omental ischemia has not been yet determined. When compared with appendicitis, omental torsion has an incidence of 0.0016 to 0.37%, which is a ratio of less than 4 cases per 1000 cases of appendicitis. The final outcome of 0.1% of laparotomies performed for acute appendicitis in children is omental torsion [3, 5, 6, 9, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32]. Leitner et al. [33] classified omental infarction into secondary and primary or idiopathic types. Torsion of the omentum, thrombosis due to various causes and congestion of the mesenteric veins were considered to be secondary, whereas cases with no identified causes are called idiopathic ischemia of the greater omentum [34, 35, 36, 37, 38, 39, 40, 41, 42, 43]. Idiopathic omental infarction was first described by Bush in 1896 [44]. It was linked to trauma, increased abdominal pressure from valsalva's manoeuver, or to engorgement of dependent omental veins after a heavy meal. Others predisposing factors include congestive heart failure, digitalis administration and occlusive vascular disease. Torsion of the greater omentum is caused by twisting of the omentum around a pivotal point, more often in a clockwise direction. Precipitating factors leading to an increased risk for omental torsion include obesity, trauma, coughing, a sudden movements or change of body position, hyperperistalsis after a copious meal, compression between the liver and the abdominal wall, increased abdominal pressure, violent exercise, sneezing or coughing, pregnancy, constant movement of the omentum by peristalsis, and the occupational use of vibrating tools. The torsion may include part of the omentum or the entire length [13945, 39, 45]. The great majority of cases of omental torsion were segmental involving the right side mainly due to the larger size and mobility of the omentum. Left-sided omental torsion is occasional but has been described [26, 46, 47].


The greater omentum is a large fold of visceral peritoneum that hangs down from the stomach, passing in front of the small intestine and reflects on itself to ascend to the transverse colon before reaching to the posterior abdominal wall. In 1906, Rutherford Morison characterized the omentum as the abdominal policeman because of its ability to travel to areas of intra-abdominal turmoil. The omentum only moves passively because bowel peristalsis and positional changes by the individual [5, 6, 7, 8, 9, 10, 11]. The first published report of torsion of the greater omentum is generally ascribed to Eitel in 1899 (although some credit deMarchetti with the first report of acute torsion of the omentum, in 1858) [48]. Omental ischemia is a benign self-limiting disorder which in unremitting cases could cause ischemic necrosis of the involved part of the omentum and in intermittent cases may be a rare cause of recurrent abdominal pain [1]. Torsion leads to omental infarction; however, omental ischemia and infarction may be present without signs of torsion at surgery. No pathological findings can be found in the abdomen of the patient apart from a large and freely mobile omentum which has been rotated one or more times around a fixed spot, usually the right epiploic artery. The distal end of the omentum becomes congested and edematous; hemorrhagic extravasation takes place into the interstitial tissue, and thrombi form in the omental veins. There is inflammatory cell infiltration of varying degrees, and if the process is of sufficient duration, then gangrene may occur. As the omentum twists, the compromised venous system causes aseptic peritonitis with sero-sanguinous fluid accumulation in the peritoneal cavity. Furthermore, the arteries are compromised; this can lead to an infarction which varies from simple edema to ischemia and gangrene of the omentum [1, 19]. If torsion of the greater omentum is left untreated, it may form a fibrous mass surrounded by adhesions which could become infected or it may be separated inside the abdominal cavity [26, 46, 47].

Clinical presentation and differential diagnosis

Omental ischemia can mimic various causes of acute abdomen [6, 7, 8, 19, 21]. Primary omental torsion is difficult to diagnose preoperatively with pinpoint accuracy limited to rates of 0.6% to 4.8% of all cases [1]. Clinical presentations are diverse, including mainly a sudden increase of pain on the right iliac fossa or right paraumbilical region, enhanced with abdominal movements, associated with signs of peritoneal irritation (guarding, rebound tenderness…), without gastrointestinal symptoms [16, 17, 43]. Other symptoms may be present, such as nausea and vomiting, and moderate fever. When a large part of the omentum is involved, a mobile tender mass might be palpable in one third of cases. Diagnosis of omental torsion is rarely made preoperatively but should become more frequent with the increasing use of CT in the diagnosis of acute abdominal conditions [22, 27, 28]. Differential diagnosis should include appendicitis, cholecystitis, pancreatitis, appendagitis, sigmoid diverticulitis, cecal diverticulitis, perforated duodenal ulcer, abdominal wall hematoma, and intestinal obstruction. In women of reproductive age, salpingitis, ovarian cyst torsion, and ectopic pregnancy should also be considered. In children, differential diagnosis should also include Meckel diverticulum and mesenteric adenitis. Finally, torsion of accessory spleen is another diagnostic possibility, due to the fact that accessory spleen, when it exists, usually resides inside the omentum. The major complications of omental torsion include rupture and intraperitoneal bleeding, filtration purulent peritonitis and intraperitoneal abscess while fibrosis and inflammatory reaction may occur at occlusion [46, 47, 48, 49, 50, 51, 52, 53, 54].

Biologic and radiologic diagnosis

It has been reported that either non-operative or preoperative diagnosis is only made in 0.6 to 4.8% of cases of omental infarction [55]. A thorough blood workup reveals normal values in some cases. Leukocytosis with increased levels of C-reactive protein of the plasma and elevated erythrocyte sedimentation rate are nearly always present [152, 52]. An abdominal X-ray is nonspecific in most cases. US and CT scan findings can be used to make a reliable diagnosis and establish the most appropriate treatment plan for the patient [22, 23, 24, 25, 26, 27, 28]. US imaging shows an ovoid or cake-like hyperechoic, non-compressible mass that is adherent to the abdominal wall at the site of maximal tenderness (located in the umbilical region or antero-laterally to the right half of the colon). Doppler sonography may show few vessels within the mass and peripheral hyperaemia. US also eliminates acute cholecystitis [12, 13, 14, 27, 56]. CT scan is considered the examination of choice in cases of acute abdomen [49, 53]. A well-circumscribed ovoid area of heterogenous fat stranding with hyperattenuated streaks located within the omentum between the anterior abdominal wall and colon present the typical findings of omental infarction on CT. CT scan findings include the classic whirling pattern of fat and vessels, plus caking and stranding of omental fat or fluid accumulation within the abdomen. However, all these findings can be observed in various other conditions, such as in lipoma, liposarcoma, angiomyolipoma, teratoma, mesenteric lipodystrophy, pseudomyxoma peritonei, epiploic appendagitis, segmental infarction of the omentum, and intestinal volvulus [49, 52]. Unfortunately, except for the whirl sign, none of the other imaging findings seem specific enough for confident diagnosis and are dependent on the operator and interpreter. The key to the diagnosis of omental torsion is the presence of concentric linear strands which are characteristic, this important radiological sign is not present in other omental diseases [57, 58, 59, 60, 61, 62, 63, 64]. As laparoscopy gain popularity, the diagnosis can now be confirmed and treated effectively in a minimally invasive fashion [29, 30, 31, 32, 65, 69].

Treatment options

There is at present no standard treatment modality for omental ischemia. Two options are predominant: conservative medical treatment and early laparoscopic surgical intervention [29, 30, 31, 43, 51, 58, 65, 66, 67, 68, 69, 70, 71, 72]. As high-quality US and CT have become part of the standard evaluation of acute abdominal conditions, the diagnosis of omental infarction has become more of a radiologic diagnosis, rather than found at the time of surgery [13, 14, 22, 24, 27]. This has led to a push for non-operative treatment, and successful conservative management has been reported in several series. Conservative treatment varies among physicians and includes all or part of the following: oral analgesics, anti-inflammatory drugs, and prophylactic antibiotics, with optimal fluid management in the first instance. Complications of conservative management include bleeding, abscesses and adhesions induced by the persistence of necrotic tissue in the abdomen. Patients under conservative treatment should be under continuous clinical and radiological observation. Follow-up after conservative treatment include US examination at four weeks to four months and CT scans at one to three years to confirm the reduction of the size of the ischemic lesion [14, 49, 52, 53]. When the patient's clinical, laboratory and radiological findings worsen or when diagnosis is doubtful or the surgeon decides that surgical intervention is required, then laparoscopy is the appropriate method for diagnosis and therapy [29, 30, 31, 43, 51, 58, 65]. Surgical management, consisting in abdominal exploration and omental necrosectomy is recommended by some authors believe that this approach will result in rapid amelioration of pain, enables patient discharge much sooner, and will prevent complications [29, 30, 51, 65]. The question of the best treatment for omental infarction diagnosed with imaging and clinical criteria remains unresolved. In the absence of studies comparing conservative versus operative treatment, conclusions drawn from case reports are difficult to support. A short trial of conservative treatment is appropriate if a diagnosis of omental infarction or torsion is made on clinical grounds and based on imaging studies. However, laparoscopic operative treatment should not be delayed more than 24–48h if no improvement is observed. Laparotomy or open surgery should only be necessary where good quality imaging and laparoscopy are not available, or rarely if laparoscopic resection is not possible [66].


Omental ischemia appears with a wide variety of clinical manifestations, thus mimicking different causes of acute abdomen. A preoperative diagnosis in most cases is difficult, and a high index of suspicion is required. Recently, high-quality CT and US have enabled us to make the preoperative diagnosis and have also provided the option of conservative treatment of the condition. Conservative treatment is an appropriate first line of treatment for the first 24–48h while resuscitation is initiated and antibiotics are administered. However, if the diagnosis is in doubt or if conservative treatment fails, then laparoscopy should be performed without delay. Laparoscopy has allowed not only a confirmation of the diagnosis but also an effective, minimally invasive treatment of the condition, with the added benefit of early recovery. Laparotomy or open surgery should only be necessary where good quality imaging and laparoscopy are not available, or rarely if laparoscopic resection is not possible.

Author contributions

B. Abboud designed the research, J. Tannoury and J. Gharios performed the research, C. Yaghi and B. Abboud analysed the data, J. Tannoury and B. Abboud wrote the paper.

Disclosure of interest

the authors declare that they have no competing interest.


Alexiou K., Ioannidis A., Drikos I., Sikalias N., Economou N. Torsion of the greater omentum: two case reports J Med Case Rep 2015 ;  9 : 16010.1186/s13256-015-0641-5[PMID: 26163136].  [cross-ref]
Amo Alonso R., Arenal Vera J.J., de la Peña Cadenato J., Loza Vargas A., Santos Santamarta F., Sánchez-Ocaña Hernández R. Infarction of the greater omentum. Case report Rev Esp Enferm Dig 2015 ; 10710.17235/reed.2015.3754/2015[PMID: 26448452].
Occhionorelli S., Zese M., Cappellari L., Stano R., Vasquez G. Acute abdomen due to primary omental torsion and infarction Case Rep Sur 2014 ;  2014 : 20838210.1155/2014/208382[PMID: 25431726].
Katagiri H., Honjo K., Nasu M., Fujisawa M., Kojima K. Omental infarction due to omental torsion Case Rep Surg 2013 ;  2013 : 37381010.1155/2013/373810[PMID: 24363947].
Park T.U., Oh J.H., Chang I.T., Lee S.J., Kim S.E., Kim C.W., and al. Omental infarction: case series and review of the literature J Emerg Med 2012 ;  42 : 149-15410.1016/j.jemermed.2008.07.023[PMID: 19097725].  [cross-ref]
Zargar N.U., Kundal A.K., Krishna A. Omental infarction-an unrecognized cause of acute abdomen Indian J Pediatr 2007 ;  74 : 87[PMID: 17264464].
Pérez Saborido B., Jiménez Romero C., Marqués Medina E., Gimeno Calvo A., Rey Pérez P., Alonso Casado O., and al. Idiopathic segmental infarction of the greater omentum as a cause of acute abdomen report of two cases and review of the literature Hepatogastroenterology 2001 ;  48 : 737-740[PMID: 11462916].
Paroz A., Halkic N., Pezzetta E., Martinet O. Idiopathic segmental infarction of the greater omentum: a rare cause of acute abdomen J Gastrointest Surg 2003 ;  7 : 805-808[PMID: 13129561].  [cross-ref]
Nagar H., Kessler A., Ben-Sira L., Klepikov I., Wiess J., Graif M. Omental infarction: an unusual cause of acute abdomen in children Pediatr Surg Int 2003 ;  19 : 677-679[PMID: 14579070].  [cross-ref]
Houben C.H., Powis M., Wright V.M. Segmental infarction of the omentum: a difficult diagnosis Eur J Pediatr Surg 2003 ;  13 : 57-59[PMID: 12664418].  [cross-ref]
Bessoud B., Buffet C. Segmental infarction of the greater omentum Presse Med 2008 ;  37 : 1178-117910.1016/j.lpm.2007.07.043[PMID: 18486435].  [inter-ref]
Coulier B., Pringot J. Pictorial essay. Infarction of the greater omentum: can US and CT findings help to avoid surgery? JBR-BTR 2002 ;  85 : 193-199[PMID: 12405101].
Miguel Perelló J., Aguayo Albasini J.L., Soria Aledo V., Aguilar Jiménez J., Flores Pastor B., Candel Arenas M.F. Omental torsion: imaging techniques can prevent unnecessary surgical interventions Gastroenterol Hepatol 2002 ;  25 : 493-496[PMID: 12361530].
Nubi A., McBride W., Stringel G. Primary omental infarct: conservative vs operative management in the era of ultrasound, computerized tomography, and laparoscopy J Pediatr Surg 2009 ;  44 : 953-95610.1016/j.jpedsurg.2009.01.032[PMID: 19433177].  [cross-ref]
Gargano T., Maffi M., Cantone N., Destro F., Lima M. Secondary omental torsion as a rare cause of acute abdomen in a child and the advantages of laparoscopic approach Eur J Pediatr Surg Rep 2013 ;  1 : 35-3710.1055/s-0033-1345280[PMID: 25755948].
Ovadia P.C., Gervasoni J.E. Idiopathic segmental infarction of the omentum mimicking acute appendicitis: report of 3 cases and literature review Surgery 2003 ;  133 : 231-232[PMID: 12605191].  [cross-ref]
Helmrath M.A., Dorfman S.R., Minifee P.K., Bloss R.S., Brandt M.L., DeBakey M.E. Right lower quadrant pain in children caused by omental infarction Am J Surg 2001 ;  182 : 729-732[PMID: 11839348].  [cross-ref]
Karayiannakis A.J., Polychronidis A., Chatzigianni E., Simopoulos C. Primary torsion of the greater omentum: report of a case Surg Today 2002 ;  32 : 913-915[PMID: 12376793].  [cross-ref]
Rao A., Remer E.M., Phelan M., Hatem S.F. Segmental omental infarction Emerg Radiol 2007 ;  14 : 195-197[PMID: 17566801].  [cross-ref]
Al-Bader I., Al-Said Ali A., Al-Sharraf K., Behbehani A. Primary omental torsion. Two case reports Med Princ Pract 2007 ;  16 : 158-160[PMID: 17303955].  [cross-ref]
Pinedo-Onofre J.A., Guevara-Torres L. Omental torsion. An acute abdomen etiology Gac Med Mex 2007 ;  143 : 17-20[PMID: 17388092].
Goh B.K., Koong H.N. Non-operative management of idiopathic segmental infarction of the greater omentum successfully diagnosed by computed tomography J Gastroenterol Hepatol 2006 ;  21 : 1638-1639[PMID: 16928237].
Wang W., Wang Z.J., Webb E.M., Westphalen A.C., Gross A.J., Yeh B.M. Omental infarction preceded by anatomically upturned omentum Clin Imaging 2013 ;  37 : 1125-112710.1016/j.clinimag.2013.07.005[PMID: 23932388].  [cross-ref]
Modaghegh M.H., Jafarzadeh R. Primary omental torsion in an old woman: imaging techniques can prevent unnecessary surgical interventions Case Rep Med 2011 ;  2011 : 54132410.1155/2011/541324[PMID: 21738534].
Fernández-Rey C.L. Primary omental infarction as cause of non-surgical acute abdomen: imaging diagnosis Rev Esp Enferm Dig 2010 ;  102 : 498-49910.4321/S1130-01082010000800007[PMID: 20670071].
Balthazar E.J., Lefkowitz R.A. Left-sided omental infarction with associated omental abscess: CT diagnosis J Comput Assist Tomogr 1993 ;  17 : 379-381[PMID: 8491897].  [cross-ref]
Coulier B. Segmental omental infarction in childhood: a typical case diagnosed by CT allowing successful conservative treatment Pediatr Radiol 2006 ;  36 : 141-143[PMID: 16328324].  [cross-ref]
Stella D.L., Schelleman T.G. Segmental infarction of the omentum secondary to torsion: ultrasound and computed tomography diagnosis Australas Radiol 2000 ;  44 : 212-215[PMID: 10849989].  [cross-ref]
Maternini M., Pezzetta E., Martinet O. Laparoscopic approach for idiopathic segmental infarction of the greater omentum Minerva Chir 2009 ;  64 : 225-227[PMID: 19365323].
Siu W.T., Law B.K., Tang C.N., Chau C.H., Li M.K. Laparoscopic management of omental torsion secondary to an occult inguinal hernia J Laparoendoscopic Adv Surg Tech A 2003 ;  13 : 199-201[PMID: 12855104].  [cross-ref]
Agresta F., Bedin N. Primary omental infarction: laparoscopic approach in two pediatric cases: a case review J Laparoendosc Adv Surg Tech A 2007 ;  17 : 831-832[PMID: 18158821].  [cross-ref]
Goti F., Hollmann R., Stieger R., Lange J. Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: report of case Surg Today 2000 ;  30 : 451-453[PMID: 10819485].  [cross-ref]
Leitner M.J., Jordan C.G., Spinner M.H., Reese E.C. Torsion, infarction and hemorrhage of the omentum as a cause of acute abdominal distress Ann Surg 1952 ;  135 : 103-110[PMID: 14895152].  [cross-ref]
Hosseinpour M., Abdollahi A., Jazayeri H., Talari H.R., Sadeghpour A. Omental torsion after repeated abdominal blunt trauma Arch Trauma Res 2012 ;  1 : 75-7810.5812/atr.6881[PMID: 24396748].  [cross-ref]
Mistry K.A., Iyer D. Torsion of the greater omentum secondary to omental lymphangioma in a child: a case report Pol J Radiol 2015 ;  80 : 111-11410.12659/PJR. 892873[PMID: 2577424; eCollection 2015].
Efthimiou M., Kouritas V.K., Fafoulakis F., Fotakakis K., Chatzitheofilou K. Primary omental torsion: report of two cases Surg Today 2009 ;  39 : 64-6710.1007/s00595-008-3794-7[PMID: 19132472].  [cross-ref]
Basson S.E., Jones P.A. Primary torsion of the omentum Ann R Coll Surg Engl 1981 ;  63 : 132-134[PMID: 7247271].
Valioulis I., Tzallas D., Kallintzis N. Primary torsion of the greater omentum in children—a neglected cause of acute abdomen? Eur J Pediatr Surg 2003 ;  13 : 341-343[PMID: 14618528].
Young T.H., Lee H.S., Tang H.S. Primary torsion of the greater omentum Int Surg 2004 ;  89 : 72-75[PMID: 15285236].
Gul Y.A., Jabbar M.F., Moissinac K. Primary torsion of the greater omentum Acta Chir Belg 2001 ;  101 : 312-314[PMID: 11868511].
al-Husaini H., Onime A., Oluwole S.F. Primary torsion of the greater omentum J Natl Med Assoc 2000 ;  92 : 306-308[PMID: 10918767].
Rao T.N., Parvathi T., Suvarchala A. Omental lymphangioma in adults-rare presentation: report of a Case Case Rep Surg 2012 ;  2012 : 62948210.1155/2012/629482[PMID: 23198248].
Lardies J.M., Abente F.C., Napolitano A., Sarotto L., Ferraina P. Primary segmental infarction of the greater omentum: a rare cause of RLQ syndrome: laparoscopic resection Surg Laparosc Endosc Percutan Tech 2001 ;  11 : 60-62[PMID: 11269560].  [cross-ref]
Bush P. A case of haemorrhage into the greater omentum Lancet 1896 ;  147 : 286 [cross-ref]
Theriot J.A., Sayat J., Franco S., Buchino J.J. Childhood obesity: a risk factor for omental torsion Pediatrics 2003 ;  112 : 460-463[PMID: 14654645].
Hirano Y., Oyama K., Nozawa H., Hara T., Nakada K., Hada M., and al. Left-sided omental torsion with inguinal hernia World J Gastroenterol 2006 ;  12 : 662-664[PMID: 16489689].  [cross-ref]
Foscolo S., Mandry D., Galloy M.A., Champiqneulles J., De Miscault G., Claudon M. Segmental omental infarction in childhood: an unusual case of left-sided location with extension into the pelvis Pediatr Radiol 2007 ;  37 : 575-577[PMID: 17404725].  [cross-ref]
Eitel G.G. Rare omental torsion NY Med Rec 1899 ;  55 : 715-716
Van Breda Vriesman A.C., Lohle P.N., Coerkamp E.G., Puylaert J.B. Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history Eur Radiol 1999 ;  9 : 1886-1892[PMID: 10602970].
Safioleas M., Stamatakos M., Giaslakiotis K., Smirnis A., Safioleas P. Acute abdomen due to primary omentitis: a case report Int Semin Surg Oncol 2007 ;  4 : 19[PMID: 17655767].  [cross-ref]
Danikas D., Theodorou S., Espinel J., Schneider C. Laparoscopic treatment of two patients with omental infarction mimicking acute appendicitis JSLS 2001 ;  5 : 73-75[PMID: 11304000].
van Breda Vriesman A.C., de Mol van Otterloo A.J., Puylaert J.B. Epiploic appendagitis and omental infarction Eur J Surg 2001 ;  167 : 723-727[PMID: 11775722].
Van Breda Vriesman A.C., Puylaert J.B. Epiploic appendagitis and omental infarction: pitfalls and look-alikes Abdom Imaging 2002 ;  27 : 20-28[PMID: 11740602].
Shin M.K., Lee O.J., Ha C.Y., Min H.J., Kim T.H. Malignant mesothelioma of the greater omentum mimicking omental infarction: a case report World J Gastroenterol 2009 ;  15 : 4856-4859[PMID: 19824125].  [cross-ref]
Tandon A.A., Lim K.S. Torsion of the greater omentum: a rare preoperative diagnosis Indian J Radiol Imaging 2010 ;  20 : 294-29610.4103/0971-3026.73540[PMID: 21423906].  [cross-ref]
Bachar G.N., Shafir G., Postnikov V., Belenky A., Benjaminov O. Sonographic diagnosis of right segmental omental infarction J Clin Ultrasound 2005 ;  33 : 76-79[PMID: 15674838].  [cross-ref]
Singh A.K., Gervais D.A., Lee P., Westra S., Hahn P.F., Novelline R.A., and al. Omental infarct: CT imaging features Abdom Imaging 2006 ;  31 : 549-554[PMID: 16465576].  [cross-ref]
Cianci R., Filippone A., Basilico R., Storto M.L. Idiopathic segmental infarction of the greater omentum diagnosed by unenhanced multidetector-row CT and treated successfully by laparoscopy Emerg Radiol 2008 ;  15 : 51-56[PMID: 17610001].
Naffaa L.N., Shabb N.S., Haddad M.C. CT findings of omental torsion and infarction: case report and review of the literature Clin Imaging 2003 ;  27 : 116-11810.1016/S0899-7071(02)00524-7][PMID: 12639779].  [cross-ref]
Abdennasser el K., Driss B., Abdellatif D., Mehci A., Souad C., Mohamed B. Omental torsion and infarction: CT appearance Intern Med 2008 ;  47 : 73-74[PMID: 18176011].
Hu Y.Y., Cohen H.L., Scriven R.J. Picture of the month. Omental infarction Arch Pediatr Adolesc Med 2007 ;  161 : 773-774[PMID: 17679659].  [cross-ref]
Kim J., Kim Y., Cho O.K., Rhim H., Koh B.H., Kim Y.S., and al. Omental torsion: CT features Abdom Imaging 2004 ;  29 : 502-504[PMID: 15136892].
Steinauer-Gebauer A.M., Yee J., Lütolf M.E. Torsion of the greater omentum with infarction: the vascular pedicle sign Clin Radiol 2001 ;  56 : 999-1002[PMID: 11795933].  [cross-ref]
Abadir J.S., Cohen A.J., Wilson S.E. Accurate diagnosis of infarction of omentum and appendices epiploicae by computerized tomography Am Surg 2004 ;  70 : 854-857[PMID: 15529836].
Costi R., Cecchini S., Randone B., Violi V., Roncoroni L., Sarli L. Laparoscopic diagnosis and treatment of primary torsion of the greater omentum Surg Laparosc Endosc Percutan Tech 2008 ;  18 : 102-10510.1097/SLE.0b013e3181576902][PMID: 18287998].  [cross-ref]
Itenberg E., Mariadason J., Khersonsky J., Wallack M. Modern management of omental torsion and omental infarction: a Surgeon's Perspective J Surg Educ 2010 ;  67 : 44-4710.1016/j.jsurg.2010.01.003[PMID: 20421090].  [cross-ref]
Fragoso A.C., Pereira J.M., Estevão-Costa J. Nonoperative management of omental infarction: a case report in a child J Pediatr Surg 2006 ;  41 : 1777-1779[PMID: 17011289].  [cross-ref]
Soobrah R., Badran M., Smith S.G. Conservative management of segmental infarction of the greater omentum: a case report and review of literature Case Rep Med 2010 ; 201010.1155/2010/765389][pii: 765389; PMID: 20886031].
Sasmal P.K., Tantia O., Patle N., Khanna S. Omental torsion and infarction: a diagnostic dilemma and its laparoscopic management J Laparoendosc Adv Surg Tech A 2010 ;  20 : 225-22910.1089/lap.2009.0287[PMID: 20180656].  [cross-ref]
Abe T., Kajiyama K., Harimoto N., Gion T., Nagaie T. Laparoscopic omentectomy for preoperative diagnosis of torsion of the greater omentum Int J Surg Case Rep 2012 ;  3 : 100-10210.1016/j.ijscr.2011.11.004[PMID: 22288058].  [cross-ref]
Sanchez J., Rosado R., Ramirez D., Medina P., Mezquita S., Gallardo A. Torsion of the greater omentum: treatment by laparoscopy Surg Laparosc Endosc Percutan Tech 2002 ;  12 : 443-445[PMID: 12496554].  [cross-ref]
Ha J.P.Y., Tang C.N., Siu W.T., Tsui K.K., Li Mk. Laparoscopic management of acute torsion of the omentum in adults JSLS 2006 ;  10 : 351-354[PMID: 17212894].

© 2016  Elsevier Masson SAS. All Rights Reserved.
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Article Outline