Torsion of the Greater Omentum in a Child (a Case Report)

Abstract

Torsion of the greater omentum is a rare cause of acute abdomen in childhood. Most patients present with acute right lower quadrant pain, and they are usually misdiagnosed as having appendicitis. Torsion of the greater omentum was seldom diagnosed preoperatively and usually diagnosed only on exploratory surgery for presumed acute appendicitis or similar abdominal emergency. Its cause is not clear, and it can be classified as secondary only when the cause of torsion is found; otherwise, it is considered of unknown origin (primary). We present a case of omental torsion diagnosed preoperatively (a 9-year-old boy presented with moderate, isolated, right flank pain, which had developed over 4 hours) by the characteristic whirl sign and a hyperechogenic image 6 cm along its long axis, which was ovoid, homogeneous and located in the right flank under the abdominal wall and treated by laparoscopic surgery. The results of the sonography and the short review of the literature is present.