Laparoscopic Management of Primary Omental Torsion

Primary omental torsion is an unusual condition, known for its rarity and for the particularity of being intraoperatively diagnosed, in nearly all cases. At the clinical evaluation, this pathology commonly mimics other etiologies of acute abdomen. Hemoperitoneum and necrosis of the omentum are rarely associated with the omental torsion, but when the association is found, then it means that the vascular injuries are irreversible and the required surgical procedure may be far more complex than simple devolvulus. In search of the treatment of choice, laparoscopy proved its effectiveness as a diagnostic and therapeutic tool, while the open surgery approach can be described in many cases as being too invasive. A 37-year-old female patient presented with the generic symptoms of acute appendicitis. Surgical treatment was initiated. During laparoscopy, the abdomen was attentively explored, highlighting the presence of a twisted omentum with hemoperitoneum and necrosis. Omental excision and peritoneal drainage were performed. The evolution was favorable. Another check-up was done at 6 months postoperatively, displaying no signs or symptoms of relapse.

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Laparoscopic Versus Open Appendectomy for the Treatment of Complicated Acute Appendicitis

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.v.8n.1p.15 ◽

2020 ◽

Vol 8 (1) ◽

pp. 15

Author(s):

Alireza Barband ◽

Amir Mangouri ◽

Changiz Gholipouri ◽

Abasad Gharedaghi

Keyword(s):

Laparoscopic Surgery ◽

Surgical Treatment ◽

Postoperative Pain ◽

Acute Appendicitis ◽

Open Surgery ◽

Surgery Group ◽

Significant Difference ◽

Duration Of Surgery ◽

Duration Of Hospitalization ◽

Complicated Acute Appendicitis

Background and Objective: Acute appendicitis is one of the most common and at the same time lethal if not treated promptly. Failure to treat this medical condition in a timely manner then it can lead to major complications that endanger the patient’s health. In these cases, surgical treatment can be done in an open or laparoscopic method. Despite some limited studies comparing the results of these two therapies, there is still insufficient information in patients with this complicated situation. The aim of this study was to evaluate the results of these two therapies in patients with complicated acute appendicitis. Materials and Methods: In this randomized controlled clinical trial, 52 patients with complicated acute appendicitis in the laparoscopic surgery group and 56 patients in the open surgery group were studied. Primary outcomes in this study were duration of surgery and secondary outcomes including wound infection, intra-abdominal abscess, postoperative pain, miscarriage, hospitalization, and need for re-surgery that were compared between the two groups. Results: Both groups were matched for age (mean 31.0 years in laparoscopic surgery group, 30.5 years in open surgery group, p = 0.81) and gender (28 men in laparoscopic surgery group, 32 men in surgical group, p = 0.73). The mean duration of surgery in the laparoscopic group was significantly longer (mean 66.8 vs. 55.1 min, p <0.001). In contrast, mean duration of hospitalization (85.2 vs 98.6 hours, p <0.001) and mean postoperative pain severity (6.3 vs 7.2, p <0.001) was more significant high in open surgery group. In other cases there was no significant difference between the two groups. Conclusion: Although in surgical treatment of complicated acute appendicitis the duration of laparoscopic surgery is longer than the open method, but the duration of hospitalization and pain intensity in laparoscopic method is significantly reduced.

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Torsion of the Omentum: A Rare Cause of Acute Abdomen in a 14-Year-Old Boy

Case Reports in Surgery ◽

10.1155/2018/7257460 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Chijioke Chinaka ◽

Shahbaz Mansoor ◽

Mohamed Salaheidin

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Acute Abdomen ◽

Acute Abdominal Pain ◽

Age Group ◽

First Line ◽

Omental Torsion ◽

Younger Age ◽

Remarkable Recovery ◽

Rule Out

Acute abdominal pain is a common surgical presentation, and most often, the first line of consideration is to rule out acute appendicitis; this is more so when the patient is an adolescent or within younger age group. In most cases, other differentials are considered before omental torsion. Omental torsion is a cause of acute abdominal pain and sometimes mimics acute appendicitis in its presentation. We present a case of a 14-yr-old boy who presented with acute abdomen with symptoms mimicking acute appendicitis. Laparoscopy revealed torsion of the omentum. Omentectomy and appendicectomy were done, and the child discharged four days after following a remarkable recovery.

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Torsion of the omentum: A rare cause of acute abdomen.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.12.6701 ◽

2021 ◽

Vol 28 (12) ◽

pp. 1869-1873

Author(s):

Sajid Malik ◽

Gul e Lala ◽

Abdullah Khan

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Ct Scan ◽

Acute Abdomen ◽

Preoperative Diagnosis ◽

Clinical Signs ◽

Lower Abdominal Pain ◽

X Rays ◽

Omental Torsion ◽

Operative Recovery

Omental torsion is a rare cause of acute abdominal pain. Diagnosis of omental torsion is usually difficult because clinical signs and symptoms are similar to other common causes of abdominal pain. The most common preoperative diagnosis is acute appendicitis and the proper preoperative diagnosis is important for the appropriate treatment option. Diagnosis of omental torsion is difficult and mainly based on ultrasound and computed tomography (CT) scan analysis. Case Presentation: A 26 years old male patient presented to emergency department with acute abdomen mimicking acute appendicitis. The chest and abdominal X-rays were normal. Due to intense clinical signs and worsening of the symptoms the patient underwent an operation with the probable diagnosis of acute appendicitis. In this case patient explored via gridiron incision, the omentum was found to be gangrenous that had encased the appendix so midline incision given. Post-operative recovery was uneventful. Conclusion: Omental torsion is highly uncommon cause of right lower abdominal pain and difficult to diagnose preoperatively. It presents with non-specific symptoms, mimicking other abdominal conditions presenting a similar clinical settings. CT scan is very helpful in diagnosis. Surgical treatment is the procedure of choice with laparoscopy being the preferable approach.

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Neuroma of the appendix, a rare cause of appendicitis and an important reason for close follow-up

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa023 ◽

2020 ◽

Vol 2020 (3) ◽

Author(s):

Gabriel A Molina ◽

Marco Alejandro Torres ◽

Mauro Santiago Montenegro ◽

Gery Daniel Sánchez ◽

Alberto Carlos Arcia ◽

...

Keyword(s):

Surgical Treatment ◽

Acute Appendicitis ◽

Acute Abdomen ◽

Preoperative Diagnosis ◽

Final Diagnosis ◽

Medical Team ◽

Rare Tumor ◽

Patient History ◽

Neural Origin

Abstract Acute appendicitis is the most common surgical pathology worldwide, frequently, the patient history and clinical examination are so similar to other appendicular pathologies that preoperative diagnosis is almost impossible for the medical team. Neuroma of the appendix is a rare tumor of neural origin that usually resembles the symptoms of acute appendicitis. Pathology along with close follow-ups are key, as the diagnosis is based on the presence of nerve neuronal cells in the appendicular lumen. Surgical treatment is recommended due to the possibility of malignancy. We present a case of a 32-year-old male patient who presented with symptoms of acute abdomen, surgery was performed and appendectomy was completed. Neuroma of the appendix was the final diagnosis.

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Torsion of lesser omentum: A rare presentation of acute abdomen

Journal of Shifa Tameer-e-Millat University ◽

10.32593/jstmu/vol1.iss1.38 ◽

2019 ◽

Vol 1 (1) ◽

pp. 41-43

Author(s):

Muhammad Abdullah Khalid ◽

Amina Amin ◽

Mohammad Amir

Keyword(s):

Laparoscopic Surgery ◽

Acute Appendicitis ◽

Ct Scan ◽

Acute Abdomen ◽

Epigastric Pain ◽

Iliac Fossa ◽

Rare Presentation ◽

Epiploic Appendagitis ◽

Omental Torsion ◽

Focal Fat

Intraperitoneal Focal Fat Infarction is a rare cause of acute abdomen. There are two types, Omental Torsion and Epiploic Appendagitis. We present a case of 19 years old male who presented to ER with severe pain in epigastrium and right iliac fossa. Clinical diagnosis of acute appendicitis was made, but epigastric pain remained unexplained. CT scan was reported as non-significant. Diagnostic Laparoscopy picked lesser omental infarction and acute appendicitis. Patient was successfully managed by Laparoscopic Surgery. Symptoms not explained by a single pathology should be thoroughly investigated. CT Scan is the best investigation. Laparoscopic surgery is an effective and safe approach for small segmental omental torsion.

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Endovascular Solutions for Iliac and Lower Extremity Junctional Injuries

Journal of Endovascular Resuscitation and Trauma Management ◽

10.26676/jevtm.v1i1.6 ◽

2017 ◽

Vol 1 (1) ◽

pp. 22-27

Author(s):

Edwin R Faulconer ◽

Rachel M Russo ◽

Anders J Davidson ◽

Meryl A Simon ◽

Erik S DeSoucy ◽

...

Keyword(s):

Lower Extremity ◽

Open Surgery ◽

Management Strategies ◽

Balloon Occlusion ◽

Vascular Injuries ◽

Endovascular Management ◽

Review Of The Literature ◽

Junctional Zone ◽

Endovascular Interventions ◽

Direct Pressure

Hemorrhage is the second leading cause of death in trauma and non-compressible torso hemorrhage is the leading cause of preventable death within this population. Vascular injuries to the pelvis and lower extremity junctional zone may be difficult to control with direct pressure and complex to approach with open surgery. Endovascular interventions such as balloon occlusion, stenting and embolization are potential alternatives or adjuncts to traditional open surgery in patients with blunt or penetrating vascular injuries to the pelvis. This review of the literature will outline contemporary endovascular management strategies for iliac and junctional zone injuries.

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Adenocarcinoma Ex Goblet Cell Carcinoid of Appendix: Two Case Reports

Case Reports in Pathology ◽

10.1155/2017/5930978 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Yu-Ting Wang ◽

Yi-Ru Li ◽

Tuan-Ying Ke

Keyword(s):

Acute Appendicitis ◽

Acute Abdomen ◽

Goblet Cell ◽

Case Reports ◽

Biological Behavior ◽

Rare Tumor ◽

Goblet Cell Carcinoid

Adenocarcinoma ex goblet cell carcinoid is a rare tumor incidentally found in specimens of appendicitis. Most patients present with acute abdomen, similar to acute appendicitis. Here we present two cases, which were found incidentally after operation. We give a brief summary about clinical and biological behavior of this entity.

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Appendicitis in puerpeium: Case report

Acta chirurgica iugoslavica ◽

10.2298/aci1104111b ◽

2011 ◽

Vol 58 (4) ◽

pp. 111-112 ◽

Cited By ~ 1

Author(s):

Milica Berisavac ◽

Biljana Kastratovic-Kotlica ◽

V. Tosic ◽

N. Markovic ◽

S. Ljustina ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Early Detection ◽

Acute Appendicitis ◽

Abdominal Wall ◽

Clinical Signs ◽

Signs And Symptoms ◽

Laboratory Infection ◽

Infection Parameters ◽

Clinical Signs And Symptoms

Acute appendicitis in puerperium is often diagnosed too late, because clinical signs can be unrelaible. Abdominal wall rigidity is rarely noticed in puerpeium because of weak abdominal wall muscles, laboratory parameters are not enough relaible and atipycal appendix presentation makes difficulties in diagnosis3,4. Knowing clinical signs and symptoms of appendicitis, possible complications and their early detection, make a chance for a good surgical outcome. Measuring of axillar and rectal temperature can take confusion in, and prolong time until surgical treatment. Leucocytosis in puerperium is not valid for diagnosis. We report a case of patient in puerperium with high laboratory infection parameters. Diagnosis of appendicitis is made based on clinical signs and symptoms, that is proved intraoperatively and histologicaly. Appendectomy without perforation carries less risks for mother and fetus.

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