Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2024; 12(24): 5596-5603
Published online Aug 26, 2024. doi: 10.12998/wjcc.v12.i24.5596
Are all primary omental infarcts truly idiopathic? Five case reports
Haldun Kar, Danial Khabbazazar, Nihan Acar, Şebnem Karasu, Halis Bağ, Fevzi Cengiz, Osman Nuri Dilek
Haldun Kar, Danial Khabbazazar, Nihan Acar, Halis Bağ, Fevzi Cengiz, Department of General Surgery, Katip Celebi University Ataturk Training and Research Hospital, İzmir 35150, Türkiye
Şebnem Karasu, Department of Radiology, İzmir Katip Celebi University, School of Medicine, İzmir 35150, Türkiye
Osman Nuri Dilek, Department of Surgery, İzmir Katip Celebi University, School of Medicine, İzmir 35150, Türkiye
Author contributions: Kar H, Khabbazazar D, and Acar N participated in the acquisition, analysis, and interpretation of the data and drafted the initial manuscript; Karasu Ş, Bag H, Cengiz F, and Dilek ON revised the article critically for important intellectual content.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Haldun Kar, MD, Associate Professor, Department of General Surgery, Katip Celebi University Ataturk Training and Research Hospital, Hasan Tahsin Street, İzmir 35150, Türkiye. haldunkar@hotmail.com
Received: February 26, 2024
Revised: May 21, 2024
Accepted: June 12, 2024
Published online: August 26, 2024
Processing time: 136 Days and 1.5 Hours
Abstract
BACKGROUND

Idiopathic omental infarction (IOI) is challenging to diagnose due to its low incidence and vague symptoms. Its differential diagnosis also poses difficulties because it can mimic many intra-abdominal organ pathologies. Although hypercoagulability and thrombosis are among the causes of omental infarction, venous thromboembolism scanning is rarely performed as an etiological investigation.

CASE SUMMARY

The medical records of the 5 cases, who had the diagnosis of IOI by computed tomography, were examined. The majority of the patients were male (n = 4, 80%) and the mean age was 31 years (range: 21-38). The patients had no previous abdominal surgery or a history of any chronic disease. The main complaint of all patients was persistent abdominal pain. Omental infarction was detected in all patients with contrast-enhanced computed tomography. Conservative treatment was initially preferred in all patients, but it failed in 1 patient (20%). After discharge, all patients were referred to the hematology department for thrombophilia screening. Only 1 patient applied for thrombophilia screening and was homozygous for methylenetetrahydrofolate reductase (A1298C mutation) and heterozygous for a factor V Leiden mutation.

CONCLUSION

IOI should be considered in the differential diagnosis in patients presenting with progressive and/or persistent right side abdominal pain. Investigating risk factors such as hypercoagulability in patients with IOI is also important in preventing future conditions related to venous thromboembolism.

Keywords: Omental infarction; Acute abdominal pain; Thrombophilia screening; Factor V Leiden; Methylenetetrahydrofolate reductase; Case report

Core Tip: Idiopathic omental infarction is a rare cause of acute abdominal pain and should be considered in the differential diagnosis in patients presenting with progressive right side abdominal pain. Omental infarction is idiopathic in cases whose etiology could not be established. Although hypercoagulability and thrombosis are among the causes of omental infarction, venous thromboembolism screening is rarely performed as an etiological investigation. Investigating risk factors such as hypercoagulability in patients with idiopathic omental infarction is crucial in preventing future conditions related to venous thromboembolism.