続発性大網捻転症の１例

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  • A CASE OF SECONDARY TORSION OF THE GREATER OMENTUM

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A 59-year-old man who had had a right inguinal hernia without any treatment was seen at the hospital because of right lower abdominal pain on August 23, 2002. There were strong tenderness and peritoneal signs in the right lower quadrant of abdomen. Abdominal CT scan visualized a tumorous shadow extending from the right frank to lower abdomen. With a diagnosis of acute appendicitis, the patient was operated on at the same day. During surgery, we confirmed slightly bloody ascites and the congestive and swollen omentum presented dark-red color due to torsion, and excised the twisted omentum. The postoperative course was uneventful, and the patient was discharged on the 14th postoperative day.<br>Torsion of the greater omentum is a relatively rare entity and is classified into spontaneous or secondary according to the absence or presence of some organic disorder. This case was diagnosed as torsion of the greater omentum secondary to the right inguinal hernia. Although clinical reports of omental torsion have been increasing recently, there are little detailed reports on secondary torsion of the greater omentum. In this paper, we present an analysis and consideration of 58 cases of secondary omental torsion seen in the Japanese literature.

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