Right lower quadrant abdominal pain: not always appendicitis but even omental torsion

Key words: Acute abdomen, Primary omental torsion, Diagnosis, Management

The primary omental torsion is a rare cause of acute abdomen in the paediatric population. This condition occurs when the omental apron pedicle twists around its longer axis, leading to oedema, ischaemia and necrosis. The article describes a rare case of a 6-year-old presenting with right lower quadrant abdominal pain. The clinical diagnosis was acute appendicitis. Surgical operation disclosed primary omental torsion. The infarcted omental segment was resected and the patient had a full recovery without complications. Omental torsion, although rare, should be considered in the differential diagnosis of acute abdomen. Laparascopy is a safe and effective approach for the diagnosis and management of primary omental torsion. Paediatricians together with surgeons should include this rare condition in the differential diagnosis of acute onset right-sided abdominal pain.