AB144. SOH21AS086. Omental infarction: an unusual cause of abdominal pain in pregnancy

Background: Omental infarction is a rare cause of abdominal pain, particularly in pregnancy. Here we present a case of a patient 18 weeks pregnant who developed an acute abdomen secondary to primary omental infarction.

Methods: Our patient presented to the emergency department on two separate occasions with worsening right upper quadrant (RUQ) pain with cholecystitis as the working diagnosis, however ultrasound was normal. The only abnormality on her bloods was an elevated C-reactive protein (CRP). The on call radiologist felt that computerized tomography (CT) was high risk for the fetus so the decision was made to take the patient to theatre for a diagnostic laparoscopy

Results: At laparoscopy we found free blood and necrotic greater omentum without any evidence of torsion. An abdominal washout was performed, drain placed and omental biopsy was taken.

Conclusions: Primary omental infarction is a rare cause of abdominal pain that often presents as an acute abdomen and should be considered when bloods don’t fit the clinical picture. It is ideally diagnosed on CT and management can be conservative although approximately 25% of patients will require surgical resection on their index admission.

Keywords: Diagnostic laparoscopy; infarction; omentum; pregnancy