Primary segmental infarction of the omentum with and without torsion

Primary segmental infarction of the omentum simulates acute appendicitis and other acute abdominal disorders. Early operation is almost always undertaken at which time the correct diagnosis is made. When other viscera are found to be normal at exploration, the omentum should be inspected specifically for infarction, especially if serous or serosanguineous fluid is present. Resection of the involved portion of the omentum, usually the right lower edge, leads to prompt recovery without complications. Two types of primary infarction are described, usually separately, depending on whether or not torsion is present. This report adds seven cases to the present collective experience of approximately 276 cases, 188 with and 88 without torsion. Our review shows that the two types have identical clinical characteristics. It is recommended that the condition be reported as a single entity, which should eliminate some of the confusion involved in studying this condition. Since early operation is usually undertaken, the natural clinical course of the disease is not well known. One of our patients, in whom operation was deferred for six weeks, is of particular interest in that he demonstrated the late findings of primary segmental infarction of the omentum.