Greater omental infarction: Uncommon cause of acute abdomen

Abstract

Objective: To present a case of non-surgical acute abdomen and the unusual radiological finding that determined the clinical management. A previously healthy 37-year-old man presented to the emergency department with a seven-day  history of constant, progressively worsening pain localized to the right iliac fossa, associated with an unspecified fever. Physical examination revealed localized tenderness and abdominal rigidity on the right side. Laboratory evaluation was largely unremarkable, except for moderate leukocytosis. Computed tomography was performed to investigate suspected acute appendicitis and demonstrated a 6.7 × 3.3 cm fat-density mass within the mesenteric fat pad, consistent with omental infarction. Omental infarction is an uncommon and often underrecognized cause of acute abdominal pain. It typically results from omental torsion or idiopathic ischemia and may clinically mimic more frequent surgical conditions, such as appendicitis. Awareness of its characteristic imaging findings is essential, as accurate radiologic diagnosis allows conservative management and helps avoid unnecessary surgical intervention.