Winner of CoW 10 July 2016
OMENTAL INFARCTION
Findings
Cake like fat density lesion with soft tissue stranding noted adjoining the hepatic flexure, just below the anterior abdominal wall - CONSISTENT WITH OMENTAL INFARCTION No free fluid is seen in the peritoneal cavity. Moderate diffuse fatty infiltration of liver noted.
Discussion
Primary omental infarction is often a hemorrhagic infarction resulting from vascular compromise related to the tenuous blood supply to the right edge of the omentum or to kinking of veins, usually those in the right side, deep within the anterior pelvis in the inferior extent of omentum The right lateral free edge of the omentum has a more tenuous blood supply than the rest of the omentum. This tenuous blood supply renders the right inferior portion of the omentum more vulnerable to infarction Patients with omental infarction usually present with subacute onset of pain in the right lower quadrant, often with a slightly elevated white blood cell coun Classically, it appears as a fatty, large (>5 cm) encapsulated mass, with soft-tissue stranding adjacent to the ascending colon. Early or mild infarction may manifest as mild haziness in the fat anterior to the colon
Ref: Imaging Manifestations of Abdominal Fat Necrosis and Its Mimics Aya Kamaya, MD, Michael P. Federle, MD, and Terry S. Desser, MD RADIOGRAPHICS November-December 2011 Volume 31, Issue 7
Findings
Cake like fat density lesion with soft tissue stranding noted adjoining the hepatic flexure, just below the anterior abdominal wall - CONSISTENT WITH OMENTAL INFARCTION No free fluid is seen in the peritoneal cavity. Moderate diffuse fatty infiltration of liver noted.
Discussion
Primary omental infarction is often a hemorrhagic infarction resulting from vascular compromise related to the tenuous blood supply to the right edge of the omentum or to kinking of veins, usually those in the right side, deep within the anterior pelvis in the inferior extent of omentum The right lateral free edge of the omentum has a more tenuous blood supply than the rest of the omentum. This tenuous blood supply renders the right inferior portion of the omentum more vulnerable to infarction Patients with omental infarction usually present with subacute onset of pain in the right lower quadrant, often with a slightly elevated white blood cell coun Classically, it appears as a fatty, large (>5 cm) encapsulated mass, with soft-tissue stranding adjacent to the ascending colon. Early or mild infarction may manifest as mild haziness in the fat anterior to the colon
Ref: Imaging Manifestations of Abdominal Fat Necrosis and Its Mimics Aya Kamaya, MD, Michael P. Federle, MD, and Terry S. Desser, MD RADIOGRAPHICS November-December 2011 Volume 31, Issue 7
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!