CD Chen, XM Chen, SC Wu

Abstract

A 5-year-old girl with acute appendicitis and omental torsion (OT), who presented with acute abdomen, is reported. The greater omentum of right upper quadrant gathered as an edematous and hard-shelled conglomeration with 7.0 cm x 6.0 cm x 4.0 cm size. It also rotated 5 x 360° by clockwise direction. At the same time, the changes of the appendix were observed. The appendix was congestive, edematous and hard-shelled, with faecolith in the tip and had no adhesion with greater omentum. The whirled omentum and appendix were removed. The patient recovered smoothly, and was discharged 7 days later. OT occurring with acute appendicitis is a rare pathological condition with generic symptoms that may mimic many acute abdominal conditions. Laparoscopy is the first choice procedure for diagnosis and treatment of acute omental torsion and acute appendicitis.