Sonographic appearance of omental infarction in children

Background. Omental infarction has been previously reported in the adult surgical and imaging literature; however, the imaging features of this entity in children have received little attention. Objective. The purpose of our study was to identify the sonographic features of omental infarction in nine children who had preoperative sonography and surgically proven omental infarction. Materials and methods. Sonographic images were reviewed and correlated with clinical information obtained from the patients' medical records, including clinical presentation, operative notes, and pathology reports. Results. In seven of the children, sonography demonstrated a focal area of moderately increased echogenicity in the omental fat in the right abdomen (a previously described finding in omental infarction). This was an isolated finding in four of these cases. In the three cases where this was not an isolated finding, the more complex sonographic appearance led to incorrect preoperative imaging diagnoses. This finding of increased echogenicity in the omental fat was not present in the two remaining patients. Conclusion. Our study confirms that foci of moderately increased echogenicity in the omentum of the right abdomen, a sonographic finding described in omental infarction in a large series in adults (and in a single prior case report in children), can be seen in children as well. However, although this is a relatively unique finding, it may be absent in some cases or may be seen in conjunction with other sonographic findings which may preclude the correct preoperative sonographic diagnosis.