Primary omental torsion diagnosed during hysterectomy
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Omental torsion is a rare cause of acute abdominal pain. It presents with nonspecific symptoms and signs of an acuteabdomen, making it difficult to diagnose preoperatively, because symptoms mimic those caused by other conditionssuch as appendicitis, cholecystitis, diverticulitis, and other gynecologic diseases. Computed tomography is an effectiveand useful method to diagnose and exclude other acute abdominal conditions. Our case presented with sudden rightupper abdominal pain with tenderness, rebound tenderness, mild fever (37.2°C), increased erythrocyte sedimentationrate (37 mm/hr), increased high-sensitivity C-reactive protein level (5.97 mg/dL). Computed tomography showed alarge, well-circumscribed heterogeneous fatty mass and a 7.3 cm subserosal myoma. We could not exclude the myomaas the cause of acute abdominal pain, so we performed an emergency operation with suspicion of omental torsion ornecrotic degeneration of the myoma. During the operation, we diagnosed primary omental torsion with infarctionand subserosal myoma without secondary degeneration.
Abstract
Omental torsion is a rare cause of acute abdominal pain. It presents with nonspecific symptoms and signs of an acuteabdomen, making it difficult to diagnose preoperatively, because symptoms mimic those caused by other conditionssuch as appendicitis, cholecystitis, diverticulitis, and other gynecologic diseases. Computed tomography is an effectiveand useful method to diagnose and exclude other acute abdominal conditions. Our case presented with sudden rightupper abdominal pain with tenderness, rebound tenderness, mild fever (37.2°C), increased erythrocyte sedimentationrate (37 mm/hr), increased high-sensitivity C-reactive protein level (5.97 mg/dL). Computed tomography showed alarge, well-circumscribed heterogeneous fatty mass and a 7.3 cm subserosal myoma. We could not exclude the myomaas the cause of acute abdominal pain, so we performed an emergency operation with suspicion of omental torsion ornecrotic degeneration of the myoma. During the operation, we diagnosed primary omental torsion with infarctionand subserosal myoma without secondary degeneration.
참고문헌 (15)
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