Practice Essentials
Omental torsion is a condition in which the organ twists on its long axis to such an extent that its vascularity is compromised. Although it is rarely diagnosed preoperatively, knowledge of this entity is important to the surgeon because it mimics the common causes of acute surgical abdomen. Eitel first described omental torsion in 1899; since then, only about 300 cases have been reported.
Omental torsion usually occurs in adults. The twisted portion of the omentum tends to be localized to a right-side segment, thereby giving rise to the sudden onset of pain and signs of peritoneal irritation on the right side of the abdomen. The condition may be associated with nausea, vomiting, or low-grade fever. An abdominal mass may be palpable.
Ultrasonography (US) and computed tomography (CT) may show a characteristic appearance of twisted omentum; however, because the disease may mimic other surgical emergencies, extensive radiologic studies are usually not indicated.
Treatment consists of resection of the affected portion of the omentum. Any disease process associated with secondary torsion should be corrected.