Omental Torsion and Infarction Management
Summary
Omental torsion and infarction represent uncommon causes of acute abdominal pain that arise from vascular compromise of the greater omentum. Twisting of this fatty apron blocks arterial inflow and venous outflow, leading to segmental or diffuse necrosis, local inflammation and clinical signs that often mimic more common conditions such as appendicitis or cholecystitis. Advances in ultrasonography and contrast-enhanced computed tomography have shifted diagnosis from intraoperative surprise to reliable preoperative recognition. Management ranges from conservative observation—with analgesics, antibiotics and close monitoring—to surgical removal of the necrotic omentum by laparoscopy or open omentectomy. Decision-making hinges on the extent of infarction, laboratory markers of inflammation and patient comorbidities. Early intervention, when indicated, can shorten hospital stay, reduce inflammatory sequelae and prevent abscess formation. These insights inform global best practice in triaging acute abdominal pain and in treating intra-abdominal fat necrosis.
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Omental Torsion and Infarction Management publication trend
The graph below shows the total number of articles in omental torsion and infarction management across all publications each year (not limited to Nature Index journals).
Technical terms
Omental torsion: Rotation of the greater omentum around its vascular pedicle, causing impaired blood flow and acute abdominal pain.
Omental infarction: Necrosis of omental tissue due to vascular occlusion, often secondary to torsion.
Conservative management: Non-operative treatment involving analgesia, antibiotics and clinical monitoring to allow spontaneous resolution.
Laparoscopic omentectomy: Minimally invasive surgical removal of the infarcted omentum via small abdominal ports under camera guidance.
References
- OMENTAL INFARCTION: SURGICAL or CONSERVATIVE TREATMENT? A CASE REPORTS and CASE SERIES SYSTEMATIC REVIEW. Annals of Medicine and Surgery (2020).
- Contribution of us and ct for diagnosis of intra peritoneal focal fat infarction (iffi): a pictorial review. Journal of the Belgian Society of Radiology (2010).
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