Torsion of the greater Omentum: clinical manifestations and diagnosis

Abstract

Torsion of the greater omentum is a rare disorder that until the present only reported 300 cases worldwide with a rate of approximate incidence of 0.3% of patients with suspected acute appendicitis. This entity was first described by Eitel in 1899. It represents one of the rare causes of acute abdomen with symptoms similar to acute appendicitis and other abdominal pathologies; It may be primary or secondary; the first is presented without evidence of pre-existing intra-abdominal pathology or etiology unknown, although that is attributable to a pedicle of the omentum very narrow or very long, and the second, or cause known, caused by external trauma, violent exercise or Peristaltic movement very accelerated, hernias, flanges or tumor; but intraoperatively is usually diagnosed, it occurs in 0.05 to 0.1% in children according to studies. Preoperative diagnosis is difficult and usually only be reached via a laparotomy Explorer and it can be confused with diseases such as acute appendicitis, pancreatitis, acute cholecystitis or duodenal ulcer perforated, among others. Because low frequency of this surgical pathology report is important cases as they arise, they are usually unsuspected until the surgery is performed.