Omental Torsion and Infarction with Right Inguinal Hernia: A Case Report

You Sung Kim; Tae Hyung Kim

doi:10.3348/jksr.2017.77.3.183

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This article has been corrected. See "Erratum: Omental Torsion and Infarction with Right Inguinal Hernia: A Case Report" in Volume 78 on page 224.

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Kim and Kim: Omental Torsion and Infarction with Right Inguinal Hernia: A Case Report

Case Report

J Korean Soc Radiol 2017;77(3):183-186.

Published online: 19 January 2017

DOI: https://doi.org/10.3348/jksr.2017.77.3.183

Omental Torsion and Infarction with Right Inguinal Hernia: A Case Report

You Sung Kim, MD^*,, Tae Hyung Kim, MD

Department of Radiology, Ilsan Paik Hospital, Inje University, Goyang, Korea

^*Corresponding author: You Sung Kim, MD Department of Radiology, Ilsan Paik Hospital, Inje University, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea. Tel. 82-31-910-7628 Fax. 82-31-910-7369 E-mail: youskim@gmail.com

Received 12 September 20167 January 2017 Accepted 14 March 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Omental torsion and infarction are rare causes of acute abdominal pain, and it is often difficult to diagnose these conditions preoperatively. There are several reports showing that computed tomography is useful to diagnose these conditions. Here, we report a case of a 59-year-old man with omental infarction due to secondary omental torsion associated with an untreated inguinal hernia. Preoperative comput-ed tomography showed a fatty mass in the right lower quadrant and a right inguinal hernia containing torsion of the greater omentum. He underwent laparoscopic par-tial omentectomy and herniorrhaphy, and the postoperative course was uneventful.

Keywords: Omentum, Torsion Abnormality, Abdomen, Acute, Hernia, Inguinal, Computed Tomography

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Fig. 1.

A 59-year-old man with omental infarction due to secondary omental torsion associated with an untreated inguinal hernia. A. Axial CT scan shows a fatty mass (arrows) with central soft-tissue attenuation and a peripheral halo in the right lower quadrant, adjacent to the sigmoid colon. B-D. On Coronal CT scan (B), a part of the fatty structure extends into the right inguinal hernia sac (arrowheads). The proximal portion of the herniated fatty structure (arrowheads) and the proximal portion of the omental torsion (arrows) are seen (C). A small dot-like soft tissue structure (line) which is suspected to be the torsion knot is noted in the juxta-proximal portion of the herniated omentum with distended venous structure extending into the ovoid-shaped mass with surrounding fat infiltration (arrows) (D). E, F. Laparoscopic finding of the inguinal hernia and infarcted omentum. Defect in the right external inguinal ring (arrows) was found and the greater omentum (arrowheads) entered into the inguinal hernia site (E) and the infarcted omentum (dotted arrows), proximal to the twisted part (F), was seen during surgery.

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