OMENTAL INFARCTION: A DIFFERENTIAL DIAGNOSIS OF ACUTE ABDOMEN

• Autor(a) principal: Matos, Mateus Santos
• Data de Publicação: 2019
• Outros Autores: Oliveira Filho, Alvaro Henrique de Souza, Vitório, Matheus de Backer, Siqueira, Luisa Azevedo, Abreu, Maitê Pessanha de Almeida, Machado, Enilton Monteiro
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Científica da Faculdade de Medicina de Campos
• Texto Completo: https://www.fmc.br/ojs/index.php/RCFMC/article/view/246
• topic: infarto omental; torção omental; abdome agudo inflamatório; Omental Infaction; omental torsion; acute inflammatory abdomen

Introduction: Omental infarction is a rare cause of acute inflammatory abdomen, with omental torsion being one of its main etiologies. The clinic of omental infarction resembles other pathologies of the acute inflammatory abdomen with nonspecific complaints. The diagnosis is usually made during imaging or surgical procedure. Objective: To describe a case of omental infarction that evolved with abscess formation. Case report: A 65 year old male patient sought care due to diffuse abdominal pain. Laboratory tests and abdominal CT were requested. Abdominal CT showed an image suggestive of segmental infarction of the major omentum with areas of peripheral necrosis. Conservative treatment was indicated, with oral antibiotics, analgesy and orientations. One week after, the pacient returned, reporting an increase in the abdominal pain, with greater intensity in the left abdominal region and fever. A new abdominal CT scan, laboratory tests and EAS were performed to evaluate the lesion evolution. The comparative study with the one performed 7 days before showed a slight increase in the inflammatory reaction of the lesion structure described above and increased to the thickening of the adjacent abdominal wall. The omentectomy of the lesion was indicated and sent for histological analysis. Patient was admitted with intravenous antibiotic therapy and after 3 days was discharged. Conclusions: In patients with acute abdomen presenting a nonspecific clinic, it is important to think of the omental infarction, because, despite being a rare pathology, it can generate complications in the event of a diagnostic error or delay.