Omental Torsion Workup

Updated: Aug 19, 2021
  • Author: Alan A Saber, MD, MS, FACS, FASMBS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Workup

Laboratory Studies

A complete blood count (CBC) may reveal moderate leukocytosis, which occurs in two thirds of cases of omental torsion.

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Imaging Studies

Reports suggest that 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.

CT may show a concentric distribution of fibrous and fatty folds converging radially toward the torsion. [11, 12] US, on the other hand, may show a complex mass and mixture of solid material and hypoechoic zones.

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Procedures

Laparoscopy is a safe diagnostic and therapeutic modality. [13, 14] In a report from Italy, for example, US and radiologic findings in three patients who presented with acute abdominal symptoms were unclear, prompting the use of diagnostic laparoscopy. [15] In another report, laparoscopic examination allowed exploration of the entire peritoneal cavity, thereby facilitating an accurate diagnosis of omental torsion, followed by laparoscopic resection of necrotic omentum, in each patient. [16]

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