Primary omental infarction: a report of a series of cases in an Indian tertiary care hospital

Ruru Ray, Ann Sunny, Giridhar Ashwath, Anthony Prakash Rozario, Rahul Sima


Primary omental infarction is a relatively rare and often presents as right sided abdominal pain. It is often diagnosed as appendicitis and is usually picked up intra-operatively, or - as often seen nowadays - on imaging. We describe a series of four cases of primary omental infarction that presented to us with varying clinical features. Three of them had a short history of right sided abdominal pain, whereas the fourth patient had a longer history of left sided abdominal pain. All 4 were managed operatively, with the fourth having presented with an intra-abdominal abscess that required laparotomy. Primary omental infarction is a diagnosis which must be considered in any case of acute abdomen. Cases diagnosed with certainty on imaging may be managed conservatively but must be followed up closely. Need for surgical intervention should be considered in select cases.


Abdominal pain, Abscess, Adult, Computed tomography, Infarction, Omentum, Omental infarction

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Park TU, Oh JH, Chang IT, Lee SJ, Kim SE, Kim CW, et al. Omental infarction: case series and review of the literature. J Emerg Med. 2012;42(2):149-54.

Kamaya A, Federle MP, Desser TS. Imaging manifestations of abdominal fat necrosis and its mimics. RadioGraphics. 2011;31(7):2021-34.

Cholakkal S, Nambiar R, Sahadevan S, Ravindran R. Acute idiopathic omental infarction as an unusual cause of left iliac fossa pain: a case report. Int Surg J. 2018;5(2):743.

Leitner MJ, Jordan CG, Spinner MH, Reese EC. Torsion, infarction and hemorrhage of the omentum as a cause of acute abdominal distress. Ann Surg. 1952;135(1):103-10.

Schlesinger AE, Dorfman SR, Braverman RM. Sonographic appearance of omental infarction in children. Pediatr Radiol. 1999;29(8):598-601.

Grattan-Smith JD, Blews DE, Brand T. Omental infarction in pediatric patients: sonographic and CT findings. Am J Roentgenol. 2002;178:1537-9.

Lindley SI, Peyser PM. Idiopathic omental infarction: One for conservative or surgical management? J Surg Case Rep. 2018;2018(3):rjx095.

Itenberg E, Mariadason J, Khersonsky J, Wallack M. Modern management of omental torsion and omental infarction: a surgeon’s perspective. J Surg Educ. 2010;67(1):44-7.

Balthazar EJ, Lefkowitz RA. Left-sided omental infarction with associated omental abscess: CT diagnosis. J Comput Assist Tomogr. 1993;17(3):379-81.

Chauhan V, Stephenson JA, Shah V. Intra-abdominal focal fat infarction of the omentum: diagnosis and percutaneous management. BJR Case Rep. 2015;1(2):20150134.