Primary infarction of greater omentum: Report of a case

A 38-year-old alcoholic male, who had had an appendectomy at 17 years of age, suffered from indolent epigastralgia for 3 days, which rapidly progressed into severe cramping abdominal pain on the right side after a heavy meal with alcohol. His symptoms initially simulated acute cholecystitis but this was later found negative by sonography. Due to progressive abdominal distention, low grade fever, and right upper quadrant pain with peritoneal sign, abdominal CT scan was arranged through a small bowel lesion. The CT scan disclosed a heterogenic wedge-shaped area with intervening fibrous bands and hyperattentulated fatty necrosis over the RUQ. The patient was subsequently operated on, and both the surgical and pathologic findings confirmed primary infarction of greater omentum with torsion. Omental infarction is a rare cause of right-side abdominal pain and occurs at any age sporadically with certain predisposing factors. Clinically, it presents as right-side abdominal pain that simulates acute cholecystitis or appendicitis. Therefore, preoperative diagnosis is not common. Specific findings of abdominal CT scan as shown in this case is a good tool for early diagnosis.