• Setthabutr Eaupanitcharoen and Watchara Wattanasoontornsakul.
• Department of Surgery, Maharat Nakhon Ratchasima Hospital, Thailand. Electronic address: setthabutr.ea@cpird.in.th.
• Int J Surg Case Rep. 2020 Jan 1; 76: 328-330.

IntroductionOmental torsion is an unusual cause of acute abdominal pain. This condition may mimic other common pathologies, for instance, appendicitis or colonic diverticulitis. As a result, the diagnosis of omental torsion could be challenging to achieve preoperatively.Presentation Of CaseA 63-year-old male patient of secondary omental torsion accompanied by the left inguinal hernia was described. The patient presented to the hospital with a painful mass occupying in the left lower quadrant of his abdomen. A computed tomography scan with intravenous contrast administration demonstrated a whirling sign of intraabdominal fatty mass extending to the left inguinal canal. Therefore, emergency laparotomy was performed. Hemorrhagic infarction of the greater omentum was observed, and double-twisting points were identified at both ends of the greater omentum. Then, the strangulated omental portion was resected. The patient recovered uneventfully and was able to be discharged home on postoperative day 4.DiscussionSecondary omental torsion has been reported more frequently than primary omental torsion. However, most of the patients were right-sided torsion. Precise diagnosis might not be possible by only clinical examination and plain abdominal radiography. The computed tomography scan, demonstrating classic whirling pattern, is useful in suspected cases. The treatment was straightforward by resection of the affected omentum.ConclusionThe omental torsion is a rare cause of acute abdominal pain and could mimic other intra-abdominal pathologies.Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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