特徴的なCT所見を呈した大網捻転症の1例

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  • A CASE OF TORSION OF THE OMENTUM WITH CHARACTERISTIC CT FINDING

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A 35-year-old man was admitted to the hospital because of abdominal pain, nausea and vomiting. Abdominal ultrasonography revealed ascites, and abdominal CT demonstrated a concentric whorl-like structure. Laparotomy was perfomed under a diagnosis of acute peritonitis due to perforation of ascending colon diverticulitis. There were a large amount of hemorrhagic ascites and a dark red mass of the greater omentum. The strangulated omentum was twised counterclockwise by 4 turns around its vessels near its attachment to the transverse colon. No other abnormal findings were present. The omentum was resected at its normal side.<br> Torsion of the omentum is a relatively rate disease and is classified into primary idiopathic type and secondary type. In this case, untreated right inguinal hernia was recognized after the opration. Therefore, this case was diagnosed as secondary omental torsion. Omental torsion has been usually obscure until operation. It is important to keep this disease in mind as one of the acute abdominal disease. And then, it might be possible to reach the correct diagnosis from the characteristic appearance by abdominal CT.

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