Camilo G Borrero MD, Presenter: Nothing to Disclose

Omar Almusa MD, Abstract Co-Author: Nothing to Disclose

Michael Peter Federle MD, Abstract Co-Author: Nothing to Disclose

Manuel Philip Meza MD, Abstract Co-Author: Nothing to Disclose

To determine if a predilection exists for primary omental infarction to occur in the right abdomen near the hepatic flexure. In contrast, secondary omental infarction can occur anywhere in the peritoneum depending on the site and form of prior surgery.

A collection of 49 cases of omental infarction diagnosed by multidetector computed tomography was gathered retrospectively at the University of Pittsburgh Medical Center and Children’s Hospital of Pittsburgh between 2002 and 2006. Demographic and clinical data were recorded including age, gender, body habitus, leukocytosis, clinical signs and symptoms, and location of the omental infarct. Surgical pathology was reviewed when available. Omental infarcts were described as primary if the patient presented without a history of prior intervention or secondary if the location and timing of the infarct could be attributed to prior surgery. The clinical outcome of a case was categorized as benign if no intervention was required for treatment of the infarct and if follow up CT imaging, when available, demonstrated resolution of the omental infarct.

Patient age ranged from 9 months to 87 years with a mean of 45.4. 48% were female and 52% percent male. 10 patients were under age 18 and the remainder above age 20. 56% of the primary omental infarcts were found in the right abdomen, anterior to the region of the hepatic flexure. 22% were found in the left abdomen and 22% in the epigastric region, just medial or anterior to the left hepatic lobe. The remaining 17 omental infarcts were categorized as secondary in patients with a history of surgery or in those with omental fat within strangulated hernias. 100% of the primary omental infarcts had a benign clinical outcome. 20% of the cases underwent interventions for issues unrelated to omental infarction.

This case series suggests primary omental infarcts often occur in the right abdomen, especially anterior to the hepatic flexure. When found in other regions, omental infarcts tend to represent stigmata of prior surgery.

CT can predict the type of omental infarct by location and distinguish omental infarcts, a self-limited process, from diseases requiring intervention.

Borrero, C, Almusa, O, Federle, M, Meza, M, Primary and Secondary Omental Infarction in Children and Adults.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4439109.html