特発性大網捻転症の1例

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  • A CASE OF PRIMARY TORSION OF THE OMENTUM

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Primary torsion of the omentum is a relatively rare entity. There have been only 36 cases in the domestic literature. In this paper a case of the disease is reported on with a review of the 37 domestic cases.<br> A 63-year-old man underwent laparotomy with a diagnosis of acute appendicitis at elsewhere, when bloody ascites was found. The surgical wound was immediately sutured and the patient was transferred to the hospital by an ambulance car. After admission laparotomy was performed under general anesthesia and the omentum twisting clockwise by seven turns was seen. A diagnosis of omental torsion was made. The omentum was excised at the site of torsion.<br> In a review of the 37 domestic cases, right lower abdominal pain was the most common complaint (24 cases; 67%). Preoperatively the disease was predominatly diagnosed as acute appendicitis in 28 cases (80%). No case was correctly diagnosed preoperatively. This disease may present difficulty in preoperative diagnosis, but it often occurs with the chief complaint of right lower abdominal pain. When acute appendicitis is suspected, we should entertain the disease a probable differential diagnosis.

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