부산대학교 도서관

Primary omental torsion is a relatively rare entity. We report a case that was diagnosed preoperatively and treated by laparoscopic operation. A 55-year-old man was admitted to our hospital complaining of moving abdominal pain. No mass was palpable, but strong tenderness was recognized in the upper abdomen. Plain computed tomography (CT) showed a low fat density mass with concentric strands on the ventral side of the middle portion of the transverse colon. Primary omental torsion was suspected based on this characteristic finding, and laparoscopic surgery was performed. Part of the omentum formed a tumorous mass, revealing a dark-red color, and the proximal side was twisted counterclockwise five times. No ascites was present. Omentectomy of the necrotic part was performed laparoscopically. Postoperative course was uneventful, and the patient was discharged 3 days after surgery. Only 5 patients with this disease have been treated by laparoscopic surgery in the Japanese literature, including this case. Abdominal CT is extremely useful for preoperative diagnosis of primary omental torsion, and a laparoscopic approach is effective for obtaining a definitive diagnosis and performing the subsequent operation.