Chen Faling,Lv Zhibao,Liu Jiangbin..Diagnosis and treatment of primary omental torsion in children[J].Journal of Clinical Pediatric Surgery,,17():699-702.
Diagnosis and treatment of primary omental torsion in children
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- Abstract:
- Objective To explore the diagnosis and treatment of primary omental torsion in children. Methods The clinical data were retrospectively reviewed for 7 boys with primary omental torsion. Clinical manifestations, laboratory tests, imaging examinations, surgical exploration and postoperative follow-ups were performed. Results The values of body mass index (BMI) were higher than those of normal counterparts. The average operative duration was (64.43±44.00)(21-120) h. Low-density lumps were detected preoperatively at the right side of abdomen. Computed tomography value was -67 ~ -55 hu and average fat density -61.57±5.26 HU. The maximal diameter of mass was 5- 8 cm with an average of 6.29±1.11 cm. The preoperative diagnosis was acute appendicitis (n=3) and necrotic omental torsion (n=4). The correct preoperative diagnostic ratio was 57.14% (4/7). All 7 cases underwent laparoscopy. Only one misdiagnosed case was converted into open surgery. The average length of hospital stay was (6.29±0.95)(5-8) days. No postoperative complications occurred during a follow-up period of 5 months to 5 years. Conclusion Obesity is an important cause of acute primary omental torsion in children. And CT examination is an effective diagnostic method of detecting fat density mass. Laparoscopic removal of necrotic tissue is preferred.
References:
1 Pinedo-Onofre JA, Guevara-Torres L. Torsion omental. An acute abdomen etiology[J]. Gac Med Mex, 2007, 143(1): 17-20. 2 Montiel-Jarquin A, Lopez-Colombo A, Nava A, et al. Clinical Characteristics of Torsion of the Omentum[J]. Gastroenterology Res, 2009, 2(4):220-223. DOI: 10.4021/gr2009.07.1303. 3 Eitel GG. Rare omental torsion. NY Med. Rec. 1899, 55:715. 4 Cremonini C, Bertolucci A, Tartaglia D, et al. Acute abdomen caused by greater omentum torsion: A case report and review of the literature[J].Ulus Travma Acil Cerrahi Derg, 2016, 22(4):391-394. DOI: 10.5505/tjtes.2015.74944. 5 Gargano T, Maffi M, Cantone N, et al. Secondary omental torsion as a rare cause of acute abdomen in a child and the advantages of laparoscopic approach[J]. European J Pediatr Surg Rep, 2013, 1(1):35-37. DOI: 10.1055/s-0033-1345280. 6 Ghosh Y., Arora R. Omental torsion[J]. J Clin Diagn Res, 2014, 8(6): NE01-2. DOI: 10.7860/JCDR/2014/9024.4479. 7 Varjavandi V, Lessin M, Kooros K, et al. Omental infarction: risk factors in children[J]. J Pediatr Surg, 2003, 38(2): 233–235. DOI: 10.1053/jpsu.2003.50051. 8 Theriot JA, Sayat J, Franco S, et al. Childhood obesity: a risk factor for omental torsion[J]. Pediatrics, 2003, 112(6 Pt 1):e460. 王利民, 刘风昌. 小儿原发性大网膜扭转1例[J]. 临床小儿外科杂志, 2007, 6(2): 37. DOI: 10.3969/j.issn.1671-6353.2007.02.031. Wang LM, Liu FC. One case of primary omentum torsion in children[J]. J Clin Ped Sur, 2007, 6(2):37.DOI: 10.3969/j.issn.1671-6353.2007.02.031. 张强, 张晋绥, 祁泳波, 等, 儿童大网膜扭转1例 [J]. 临床小儿外科杂志, 2013, 12(4): 341. DOI: 10.3969/j.issn.1671-6353.2013.04.029. Zhang Q, Zhang JS, Qi YB, et al. Omental torsion in children: one case report[J], J Clin Ped Sur, 2013, 12(4):341. DOI:10.3969/j.issn.1671-6353.2013.04.029. 11 Hirono S, Sakaguehi S, 1wakura S, et a1. Omental torsion secondary to right inguinal hernia: case report and cumulative review of the English literature[J]. Int Surg, 2007, 92(4):187-197. 12 Madha ES, Kane TD, Manole MD. Primary Omental Torsion in a Pediatric Patient: Case Report and Review of the Literature.[J]. Pediatric Emergency Care, 2018, 34(2):e32.DOI: 10.1097/PEC.0000000000001230. 13 Alexiou K, Ioannidis A, Drikos I, et al. Torsion of the greater omentum: two case reports[J]. Journal of Medical Case Reports,9,1(2015-07-11), 2015, 9(1):160. DOI: 10.1186/s13256-015-0641-5. 14 Hosseinpour M, Abdollahi A, Jazayeri H, et al. Omental torsion after repeated abdominal blunt trauma[J]. Archives of Trauma Research, 2012, 1(2):75-78. DOI: 10.5812/atr.6881. 15 Abe T, Kajiyama K, Harimoto N, et al. Laparoscopic omentectomy for preoperative diagnosis of torsion of the greater omentum[J]. Int J Surg Case Rep, 2012, 3(3):100-102. DOI: 10.1016/j.ijscr.2011.11.004. 16 Andreuccetti J1, Ceribelli C, Manto O, et al. Primary omental torsion (pot): review of literature and case report [J]. World J Emerg Surg, 2011, 6:6. DOI: 10.1186/1749-7922-6-6. 17 Wertheimer J, Galloy MA, Régent D, et al. Radiological, clinical and histological correlations in a right segmental omental infarction due to primary torsion in a child[J]. Diagn Interv Imaging, 2014, 95(3):325-331. DOI: 10.1016/j.diii.2013.05.009.