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.