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Omental Volvulus

Omentum Torsion


Presentation

  • Gastric LCH present with chronic malena [21] and iron deficiency anemia. Duodenal lesions have presented with anemia unresponsive to iron therapy [22] or with overt upper GI bleeding.[mjdrdypu.org]
  • As a result of right sided torsion, the presentation usually mimics acute cholecystitis, acute appendicitis, cecal diverticulitis and epiploic appendagitis.[tropicalgastro.com]
  • It usually presents with acute onset right-sided abdominal pain. The most common risk factors are adult male between 40 and 50 years of age and obesity.[jdrntruhs.org]
  • The second such case is presented, together with a brief review of available literature. The pathogenesis of omental foraminae is discussed, and an additional aetiological mechanism is proposed.[unboundmedicine.com]
  • In the present study, we discuss a rare exposure of an untreated indirect or oblique inguinal hernia in about a 60 year old male formalin fixed cadaver noticed during routine dissection of the abdomen for the first MBBS students in Late Shri Lakhiram[ijcrls.com]
Soft Tissue Mass
  • There is no evidence of a soft-tissue mass. Figure 1b. Supine (a) and erect (b) radiographs of the abdomen show multiple dilated loops of small intestine in the upper abdomen. There is no evidence of a soft-tissue mass. Figure 2a.[pubs.rsna.org]
  • Contrast-enhanced computed tomography (CECT) scan of abdomen [Figure 1] and [Figure 2] showed a large, well-defined soft tissue mass in the lower abdomen extending into the pelvis on the left side measuring 8.4 cm 6.6 cm 9.4 cm in size showing contrast[mjdrdypu.org]
Peritoneal Disease
  • Source MeSH Adult Colostomy Diagnosis, Differential Female Hernia Herniorrhaphy Humans Intestinal Obstruction Omentum Peritoneal Diseases Radiography Sigmoid Diseases Pub Type(s) Case Reports Journal Article Review Language eng PubMed ID 2183747 Citation[unboundmedicine.com]
  • Keywords : Acute Abdomen, Mesentery, Omentum, Peritoneal Diseases, Tomography.[casereports.in]
Peritoneal Disease
  • Source MeSH Adult Colostomy Diagnosis, Differential Female Hernia Herniorrhaphy Humans Intestinal Obstruction Omentum Peritoneal Diseases Radiography Sigmoid Diseases Pub Type(s) Case Reports Journal Article Review Language eng PubMed ID 2183747 Citation[unboundmedicine.com]
  • Keywords : Acute Abdomen, Mesentery, Omentum, Peritoneal Diseases, Tomography.[casereports.in]
Papule
  • The cutaneous LCH usually occurs in children or young adults as a solitary glistening red papule or nodule that is prone to bleeding and ulceration.[mjdrdypu.org]
Purpura
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
Neglect
  • A neglected cause of acute abdomen. Eur J Pediatr Surg 2003;13:341-343. Young TH. Primary torsion of the greater omentum. Int Surg 2004;89:72-75. Freed JS, Edelman S. Primary torsion of the greater omentum mimicking duodenal ulcer.[medigraphic.com]
  • Primary torsion of the greater omentum in children: a neglected cause of acute abdomen. Eur J Pediatr Surg. 2003 Oct;13(5):341-3. PubMed Google Scholar Poujade, Olivier MD, Ghiles, Eva MD, Senasli, Ali MD.[panafrican-med-journal.com]

Workup

  • A thorough blood workup reveals normal values in many cases [ 4 , 13 ]. The great majority of cases of omental torsion and infarction reported in the literature were segmental involving the right side of the omentum [ 14 , 15 ].[hindawi.com]
  • Lab workup and ultrasound were unremarkable. Management options were discussed with the patient and diagnostic laparoscopy was planned.[jpma.org.pk]
Occult Blood Positive
  • Although GI lesions are typically solitary, multiple ( 10) GI lesions have been reported in a single patient. [16] These lesions were detected in the sigmoid colon of a patient presenting with diarrhea and occult blood positive stool.[mjdrdypu.org]

Treatment

  • Although cases of conservative treatment of primary torsion have been described in cases of partial volvulus, the treatment of complete torsion of the greater omentum with secondary necrosis is surgical [ 3 ].[em-consulte.com]
  • Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances.[books.google.de]
  • The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes. Surg Endosc 1998;12:911-4. 5. Morris JH. Torsion of the Omentum. Arch Surg 1932;24:40. 6. Pinedo-Onofre JA, Guevara-Torres L. Omental torsion.[sjmms.net]
  • In all cases diagnosis was made by means of laparotomy, treatment was the resection of the affected segment, and there were no further complications.[gastrores.org]
  • The aetiology is as yet unknown and the treatment of choice, once diagnosis is established, is resection of the torted omentum.[psasir.upm.edu.my]

Prognosis

  • […] quadrant streaks of whirling and concentric pattern ( whirl sign ) whirling pattern may not be visualized if the axis of rotation is not perpendicular to the transverse scanning plane 1 free fluid may be detected in the peritoneal cavity Treatment and prognosis[radiopaedia.org]
  • The prognosis for primary omental torsion POT is good with fast post operative recovery and minimal morbidity.[jpma.org.pk]
  • The prognosis for primary omental torsion is good with fast post operative recovery and minimal morbidity.[wjes.biomedcentral.com]
  • Prognosis is excellent after surgery. Most children with mesenteric and omental cysts who undergo surgery have no long-term complications. Complications Wound infection—occurs rarely Recurrence—occurs rarely Updated: 11/2016 Author: Romeo C.[eapsa.org]

Etiology

  • An acute abdomen etiology. Gac Med Mex 2007;143:17-20. 7. Chew DK, Holgersen LO, Friedman D. Primary omental torsion in children. J Pediatr Surg 1995;30:816-7. 8. Floyd MS Jr, Kelly BJ, Udani P, O'Donnell N, Morrison P.[sjmms.net]
  • Primary (idiopathic) version is much less common and predisposing factors such as bifid omentum, redundant omental veins are suggested in etiology.[tropicalgastro.com]
  • An acute abdomen etiology. Gac Med Mex 2007;143:17-20. 2. Liebermann-Meffert D. The greater omentum. Anatomy, embryology, and surgical applications. Surg Clin North Am 2000;80:275-93, xii. 3. Al-Husaini H, Onime A, Oluwole SF.[jdrntruhs.org]
  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Definition / general Complete twisting of loop of bowel around its mesenteric base of attachment, causing obstruction and infarction Terminology Also called torsion (volvulus is a more specific term referring to gastrointestinal torsion) Etiology Potentially[pathologyoutlines.com]

Epidemiology

  • Epidemiology xxx Diagnosis xxx Clinical Manifestations Acute Gastric Volvulus Cardiovascular Manifestations Hypovolemia/Hypotension (see Hypotension , [[Hypotension]]) Gastrointestinal Manifestations Abdominal/Gastric Distention (with Stomach Filled with[mdnxs.com]
  • Lobular capillary hemangiomas: An epidemiologic report, with emphasis on cutaneous lesions. J Am Acad Dermatol 2000;42:1012-6. 6. Weiss SW, Goldblum JR, editors. Enzinger & Weiss's Soft Tissue Tumors. 5 th ed., Ch. 22.[mjdrdypu.org]
  • Epidemiology Gastric volvulus occurs in children usually less than 1 year of age and occurs in older adults, those who are older than 50 years. There does not seem to a predilection for gastric volvulus for either gender or race.[statpearls.com]
  • Lymphatic tissue : Part of the circulatory system that collects extra fluid (called lymph) from various tissues and delivers it back to the venous system Epidemiology Mesenteric and omental cysts are rare but are seen in 1 in every 100,000 adult hospital[eapsa.org]
Sex distribution
Age distribution

Pathophysiology

  • Most cases of secondary torsion occur in patients with inguinal hernias. [5] Pathophysiology In omental torsion, the omentum twists around a pivotal point, usually in a clockwise direction.[thehealthscience.com]
  • Gastrointestinal Disease: Pathophysiology, Diagnosis, Management . 5th ed. Philadelphia, Pa: Saunders; 1993:481-3.: Oltmann H. Inaugural discussion. Kiel. 1899. Palanivelu C, Rangarajan M, Shetty AR, Senthilkumar R.[emedicine.medscape.com]
  • Pathophysiology Gastric volvulus causes a foregut obstruction in the patients. Gastric volvulus may present either acutely, or it may present with intermittent, recurrent, and chronic symptoms.[statpearls.com]
  • The pathophysiology in our case can be hypothesized by laxity of all 4 gastric ligaments predisposed pancreas for directly brunt. The trauma would have induced pancreatitis in an already compromised organ due to chronic stretch.[tropicalgastro.com]

Prevention

  • […] content of the hernia, and also on the morphological and structural adjustments occurring within the abdomino-pelvic cavity to accommodate a long standing, non-strangulated and untreated inguinal hernia so as make the surgeons aware and conscious and to prevent[ijcrls.com]
  • Early management of mesenteric cyst prevents catastrophes: A single centre analysis of 17 cases.[afrjpaedsurg.org]
  • It contains fat, prevents friction, and aids in localizing infections.[medical-dictionary.thefreedictionary.com]
  • The patient is appropriately padded to prevent pressure ulcers and neuropathies.[dovepress.com]
  • […] injection of a contrast medium into the gastroepiploic vein in the base of the omentum. omentorrhaphy Suture or repair of the omentum. omentosplenopexy A surgical procedure in which the omentum and the spleen are suspended from the abdominal wall to prevent[wordinfo.info]

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