Omental Infarction in Children

Objectives To analyze the clinical presentation, radiologic features, management, and outcome in children diagnosed with omental infarction. Study design This was a retrospective chart review of patients diagnosed with omental infarction in a tertiary care pediatric emergency department. Images and reports of the radiologic investigations were re-examined by a staff radiologist and analyzed for sensitivity. Results A diagnosis of omental infarction was made in 19 children (mean age, 9.3 +/- 3.5 years). The presentation was acute right lower quadrant pain in 47% of the children and associated gastrointestinal symptoms in 63%. The sensitivity of abdominal ultrasound (US) to detect omental infarction at our institution was 64%, and the sensitivity of abdominal computed tomography was 90%. Fourteen children were treated conservatively without complications after an accurate diagnosis of omental infarction done by imaging examination. Only 5 children underwent surgery based on clinical suspicion of appendicitis. Conclusions Early identification of omental infarction by abdominal US appears to prevent unjustified surgical procedures and reduce the length of hospital stay. (J Pediatr 2009; 155:427-31).