Laparoscopic omentectomy for preoperative diagnosis of torsion of the greater omentum

INTRODUCTION: Torsion of the greater omentum is unusual. In most cases, the preoperative diagnosis was difficult due to the non-specific clinical presentation. PRESENTATION OF CASE: We present a case of greater omental torsion in a 28-year-old man with an untreated right inguinal hernia since childhood. Computed tomography (CT) revealed characteristic signs of omental torsion, which was important in making correct diagnosis. We made correct preoperative diagnosis and performed laparoscopic omentecomy. The greater omentum distal to the twisted part was dark red and showed necrotic change. This case was secondary omental torsion associated with a right inguinal hernia. DISCUSSION: Omental torsion should always be included in the differential diagnosis of acute abdomen. CONCLUSION: CT multi-planar reconstruction (MPR) imaging played a particularly important role in making a precise diagnosis. Laparoscopic approach could be useful in both diagnostic and therapeutic intervention. A successful laparoscopic omentectomy was performed in the present case. (C) 2011 Surgical Associates Ltd. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.