Idiopathic Segmental Infarction of Omentum A Rare Entity.

Idiopathic segmental Omental infarction is rare cause of acute abdomen. We present a case of a 45-year old man presented with right lower quadrant abdominal pain without gastrointestinal symptoms having no significant past history. Examination revealed localised tenderness and rebound tenderness with ill-defined lump of approx 10x10 cm2 size in the right lower quadrant of abdomen. Ultrasonography (US) showed phlegmonas mass of omentum with trapped mild fluid. Contrast enhanced Computed tomography (CT) scan showed ovoid hypo-dense fat density lesion with stranding of fat in right lower paraumbilical region beneath the abdominal wall, showing insignificant post contrast enhancement, suggestive of segmental Omental infarction. Initially conservative treatment was started but it failed. On exploratory laparotomy the omentum was found to be grossly black-brown colour and thickened without torsion. e infarcted segment of the omentum was resected. Histopathological examination revealed fat necrosis with infiltration by acute inflammatory cells. Summary: Idiopathic segmental omental infarction is rare cause of acute abdomen mimicking other abdominal pathology. Enhanced CT is helpful. Omentum should be explored routinely when other viscera found to be normal or serosanguineous fluid found. It can be managed conservatively, surgery being reserved for unclear radiological findings or clinical deterioration.