Omental Infarction: a Reappraisal of Conservative Management in Children
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996 |
Resumo: | Introduction: Accurate recognition of omental infarction has resulted in increasing supporters of non-operative approach. In order to assess the efficacy and safety of conservative management, we surveyed the cases of omental infarction treated at a single institution.Material and Methods: Primary omental infarction treated between 2004 and 2011 were reviewed. Cases recognized by imaging studies were submitted to conservative treatment that consisted of intravenous analgesics and antibiotics. Demographics, clinical presentation, laboratory findings, imaging diagnosis and outcome were analyzed.Results: There were 9 cases of omental infarction. Eight patients (4 males; median age, 8.5 years) presented at initial course of disease; all had right-sided abdominal pain and a normal or lightly increased leukocyte count. Six cases, diagnosed by CT scan after US suspicion in four, were managed conservatively, recovered uneventfully, and were discharged after a median hospital stay of 3 days. Two patients were only recognized at surgery. An additional case presented with intestinal obstruction due to an internal hernia and was successfully resolved by laparoscopy.Discussion: Imaging techniques were diagnostic of omental infarction in the majority of cases, enabling a conservative approach to be adopted. Non-operative management was successful with no complications in all patients presenting at the initial course of disease. One patient presented with a harmful complication that required operative treatment.Conclusion: In the absence of a standard approach for omental infarction, conservative management is an effective noninvasive alternative but it claims for active surveillance.Keywords: Infarction; Omentum. |
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Omental Infarction: a Reappraisal of Conservative Management in ChildrenEnfarte do Omento: Avaliação do Tratamento Conservador em Idade PediátricaIntroduction: Accurate recognition of omental infarction has resulted in increasing supporters of non-operative approach. In order to assess the efficacy and safety of conservative management, we surveyed the cases of omental infarction treated at a single institution.Material and Methods: Primary omental infarction treated between 2004 and 2011 were reviewed. Cases recognized by imaging studies were submitted to conservative treatment that consisted of intravenous analgesics and antibiotics. Demographics, clinical presentation, laboratory findings, imaging diagnosis and outcome were analyzed.Results: There were 9 cases of omental infarction. Eight patients (4 males; median age, 8.5 years) presented at initial course of disease; all had right-sided abdominal pain and a normal or lightly increased leukocyte count. Six cases, diagnosed by CT scan after US suspicion in four, were managed conservatively, recovered uneventfully, and were discharged after a median hospital stay of 3 days. Two patients were only recognized at surgery. An additional case presented with intestinal obstruction due to an internal hernia and was successfully resolved by laparoscopy.Discussion: Imaging techniques were diagnostic of omental infarction in the majority of cases, enabling a conservative approach to be adopted. Non-operative management was successful with no complications in all patients presenting at the initial course of disease. One patient presented with a harmful complication that required operative treatment.Conclusion: In the absence of a standard approach for omental infarction, conservative management is an effective noninvasive alternative but it claims for active surveillance.Keywords: Infarction; Omentum.Introdução: A melhoria da acuidade diagnóstica do enfarte do omento resultou num incremento da atitude conservadora no seu tratamento. Com o objectivo de avaliar a eficácia e segurança da abordagem não-operatória, analisámos os casos de enfarte do omento tratados num hospital terciário.Material e Métodos: Incluímos os casos de enfarte do omento primários tratados entre 2004 e 2011. Os enfartes do omento diagnosticados por imagiologia foram submetidos a tratamento conservador que constou de analgésicos e antibioterapia intravenosa. Avaliámos os dados demográficos, apresentação clínica, dados laboratoriais, imagiologia e resultado.Resultados: Ocorreram nove casos de enfarte do omento. Oito pacientes (4 rapazes), com uma idade mediana de 8,5 anos, apresentaram-se na fase inicial da doença por dor abdominal à direita; a contagem leucocitária era normal ou ligeiramente elevada. Seis casos, diagnosticados por TC após ecografia suspeita de enfarte do omento em quatro, foram trados conservadoramente sem complicações, tendo alta ao terceiro dia (mediana). Dois doentes foram apenas diagnosticados durante a intervenção cirúrgica por suposta apendicite. O nono caso apresentou-se com uma obstrução intestinal devida a hérnia interna que foi resolvida por laparoscopia.Discussão: A imagiologia foi diagnóstica na maioria dos casos de enfarte do omento, permitindo a adoção de uma abordagem conservadora. O tratamento não-operatório foi eficaz e sem complicações em todos os doentes que se apresentaram na fase inicial da doença. Um doente apresentou-se com uma complicação grave que requereu intervenção cirúrgica.Conclusão: Na ausência de um tratamento consensual para o enfarte do omento, a abordagem não-operatória é uma alternativa não invasiva e eficaz, mas requer uma vigilância clínica ativa.Palavras-chave: Enfarte; Omento.Ordem dos Médicos2014-08-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegimage/jpegimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996oai:ojs.www.actamedicaportuguesa.com:article/4996Acta Médica Portuguesa; Vol. 27 No. 4 (2014): July-August; 433-436Acta Médica Portuguesa; Vol. 27 N.º 4 (2014): Julho-Agosto; 433-4361646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/4027https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/7045https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/7184https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/7355Estevão-Costa, JoséAlvarenga, Ana SofiaFragoso, Ana CatarinaGarcia, MariaCampos, Miguelinfo:eu-repo/semantics/openAccess2022-12-20T11:04:10Zoai:ojs.www.actamedicaportuguesa.com:article/4996Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:01.149541Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Omental Infarction: a Reappraisal of Conservative Management in Children Enfarte do Omento: Avaliação do Tratamento Conservador em Idade Pediátrica |
title |
Omental Infarction: a Reappraisal of Conservative Management in Children |
spellingShingle |
Omental Infarction: a Reappraisal of Conservative Management in Children Estevão-Costa, José |
title_short |
Omental Infarction: a Reappraisal of Conservative Management in Children |
title_full |
Omental Infarction: a Reappraisal of Conservative Management in Children |
title_fullStr |
Omental Infarction: a Reappraisal of Conservative Management in Children |
title_full_unstemmed |
Omental Infarction: a Reappraisal of Conservative Management in Children |
title_sort |
Omental Infarction: a Reappraisal of Conservative Management in Children |
author |
Estevão-Costa, José |
author_facet |
Estevão-Costa, José Alvarenga, Ana Sofia Fragoso, Ana Catarina Garcia, Maria Campos, Miguel |
author_role |
author |
author2 |
Alvarenga, Ana Sofia Fragoso, Ana Catarina Garcia, Maria Campos, Miguel |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Estevão-Costa, José Alvarenga, Ana Sofia Fragoso, Ana Catarina Garcia, Maria Campos, Miguel |
description |
Introduction: Accurate recognition of omental infarction has resulted in increasing supporters of non-operative approach. In order to assess the efficacy and safety of conservative management, we surveyed the cases of omental infarction treated at a single institution.Material and Methods: Primary omental infarction treated between 2004 and 2011 were reviewed. Cases recognized by imaging studies were submitted to conservative treatment that consisted of intravenous analgesics and antibiotics. Demographics, clinical presentation, laboratory findings, imaging diagnosis and outcome were analyzed.Results: There were 9 cases of omental infarction. Eight patients (4 males; median age, 8.5 years) presented at initial course of disease; all had right-sided abdominal pain and a normal or lightly increased leukocyte count. Six cases, diagnosed by CT scan after US suspicion in four, were managed conservatively, recovered uneventfully, and were discharged after a median hospital stay of 3 days. Two patients were only recognized at surgery. An additional case presented with intestinal obstruction due to an internal hernia and was successfully resolved by laparoscopy.Discussion: Imaging techniques were diagnostic of omental infarction in the majority of cases, enabling a conservative approach to be adopted. Non-operative management was successful with no complications in all patients presenting at the initial course of disease. One patient presented with a harmful complication that required operative treatment.Conclusion: In the absence of a standard approach for omental infarction, conservative management is an effective noninvasive alternative but it claims for active surveillance.Keywords: Infarction; Omentum. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-08-25 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996 oai:ojs.www.actamedicaportuguesa.com:article/4996 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/4996 |
dc.language.iso.fl_str_mv |
eng |
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eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/4027 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/7045 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/7184 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4996/7355 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf image/jpeg image/jpeg image/jpeg |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 27 No. 4 (2014): July-August; 433-436 Acta Médica Portuguesa; Vol. 27 N.º 4 (2014): Julho-Agosto; 433-436 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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