Omental Torsion Workup

Updated: Oct 19, 2015
  • Author: Alan A Saber, MD, MS, FACS, FASMBS; Chief Editor: John Geibel, MD, DSc, MSc, 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 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. [9, 10] Ultrasonography, 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. [11, 12] In a report from Italy, for example, ultrasonographic and radiologic findings in three patients who presented with acute abdominal symptoms were unclear, prompting the use of diagnostic laparoscopy. [13] Because laparoscopic examination allowed exploration of the entire peritoneal cavity, an accurate diagnosis of omental torsion, and laparoscopic resection of necrotic omentum, was achieved in each patient, according to the report. [14]

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