Idiopathic omentum infarction in children — the law of "paired cases": cases report

BACKGROUND: One of the rare causes of abdominal pain in children is an omental infarction. In the literature, there are few descriptions of this pathology in childhood. The disease is often diagnosed only intraoperatively because of its nonspecific clinical picture. Therefore, the clinical cases presented in the article may be of interest to pediatric surgeons.

CASES REPORT: In the pediatric surgical department of our clinic, two patients aged five and six years old were treated after being admitted with abdominal pain syndrome, the clinical picture of which did not allow to exclude an acute surgical pathology. A laparoscopy was performed to clarify the diagnosis. Isolated lesions of the segments of the greater omentum were revealed without signs of torsion and pathology of other organs. The operations were completed by resection of the altered omental sections. Histopathological examination revealed hemorrhages and tissue necrosis.

DISCUSSION: The localization of pain in the right abdomen necessitates differentiating the disease from acute appendicitis, cholecystitis, and acute gynecological pathology. In the treatment of patients with omental infarction, there are supporters of conservative and surgical strategies. We performed a resection of the affected omental segment, which enabled us to achieve complete recovery in both cases.

CONCLUSION: Laparoscopy in unclear diagnostic situations permits the timely diagnosis of an omental infarction, and surgical minimally invasive intervention leads to a successful cure.