Omental disease
Omental cysts
[edit | edit source]- Epidemiology
- Most common in children and young adults
- Pathophysiology
- Thought to arise from congenital or acquired obstruction of omental lymphatics
- Can be unilocular or multilocular
- Lined by lymphatic endothelium
- Presentation
- Usually found incidentally, asymptomatic
- Larger cysts may present as a palpable abdominal mass
- Differential diagnosis
- Cysts and solid tumours of the mesentery, peritoneum, and retroperitoneum
- Diagnosis
- By excision of the cyst, which is also curative
- Complications
- Torsion
- Infection
- Rupture
Omental torsion or infarction
[edit | edit source]- Pathophysiology
- Axial twisting of the omentum along its long axis
- Primary - no co-existing causative condition is identified
- Usually right side of the omentum
- Secondary - hernia, tumour, adhesion
- Presentation
- Acute onset severe abdominal pain, localised to the right side of the abdomen
- Nausea and vomiting may be present
- Usually quite localised abdominal findings
- Frequently, the patient's presentation justifies laparoscopy/laparotomy, and the condition is diagnosed intra-operatively
- Treatment
- Resection of the involved omentum and correction of any related condition
Omental neoplasms
[edit | edit source]- Extremely rare
- Usually soft tissue sarcomas
- Metastatic disease can spread to the omentum from intra-abdominal or pelvic malignancies