• Pediatric emergency care · Dec 2021

    Omental Infarction: An Underrecognized Cause of Right-Sided Acute Abdominal Pain in Children.

    • Giovanni Di Nardo, Marco Di Serafino, Giovanni Gaglione, Carmela Mercogliano, Luigi Masoni, Maria Pia Villa, Pasquale Parisi, Chiara Ziparo, Francesca Vassallo, Melania Evangelisti, Gianfranco Vallone, and Francesco Esposito.
    • From the NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome.
    • Pediatr Emerg Care. 2021 Dec 1; 37 (12): e1555e1559e1555-e1559.

    ObjectiveTo evaluate the prevalence of omental infarction (OI) in children with suspected appendicitis, the role of ultrasonography (US) in its diagnosis and management and the efficacy of conservative management.MethodsConsecutive children with suspected acute appendicitis were prospectively enrolled. Ultrasonography was performed at baseline, during follow-up, before the discharge, and at 15-day intervals until US findings of OI disappeared. All children with a diagnosis of OI were treated conservatively.ResultsOne hundred ninety-nine children (91 male; age range, 3-15 years) were evaluated. Eighty-four patients had acute appendicitis. Omental infarctions were found in 14 children (8 male; mean age, 9.8 ± 2.6 years), with an incidence of 7%. Ultrasonography depicted an echogenic mass consistent with OI in all children. Ultrasonography detected in 8 patients a normal-looking appendix, whereas in other 6 patients, it identified neither appendix nor indirect signs of acute appendicitis. A normal appendix has been detected by US during follow-up in 2 of these 6 patients. During follow-up, US finding of OI disappeared in all cases and no signs of acute appendicitis or other disease occurred. All 14 OIs were treated conservatively, with no reported complications.ConclusionsOmental infarction is an underestimated cause of abdominal pain in children accounting for 7% of patients with suspected appendicitis. Ultrasonography is a useful method for the diagnoses and to guide clinical management of OI. Conservative therapy is a safe option for the management of OI.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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