General Abdomen: Omental Torsion

Omental Torsion

Basics

  • Omentum Twists Upon Long Axis/Vascular Pedicle, Compromising Vasculature
  • Mimics Perforation & Often Diagnosed at Surgery

Causes

  • Primary Torsion – No Underlying Pathology
    • Very Rare
    • Unipolar (One End Free)
    • Usually on the Right & Confused with Appendicitis
  • Secondary Torsion – Associated with Another Pathology (Scarring/Mass)
    • Most Common
    • Bipolar (End Opposite Vascular Pedicle Fixed)

Risk Factors

  • Obese/Fatty Omentum
  • Bifid Omentum
  • Narrowed Omental Pedicle

Treatment

  • Stable: Observation
  • Unstable or Failure: Resection of Diseased Omentum

Omental Torsion at Laparoscopy 1

References

  1. Dhooghe V, Reynders D, Cools P. Torsion of a bifid omentum as a rare cause of acute abdomen: a case report. J Med Case Rep. 2016 Oct 19;10(1):289. (License: CC BY-4.0)