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Suggest Treatment For Omental Infarction
Question: Hi, my husband is 62...low Cholesterol, BP, Bl Sugar, exercises regularly but is overweight. About a year ago he would randomly and violently start to vomit with no attached reason. A few months would pass and this would happen again. So random we never thought much of it. Two days after Christmas this past year he experienced excruciating middle side abdominal pain, rendering him unable to move or walk. We went to the Vanderbilt ER here in TN and they diagnosed him with an Omental Infarction. No treatment was suggested outside of recommended rest and OC pain meds as needed. The severe pain subsided but has not gone away completely. He has had other episodes of rapid onset severe vomiting, his stomach seems very distended, as well as increased and almost incapacitating fatigue and mild constant nausea. He has continued to exercise when he can, however the right sided abdominal pain he experienced at Christmas has now spread across and to the other side as well. We have an appt. for next week with his internist. I am just wondering if you have any suggestions for questions we can ask. Do you think he still has an infarction of the omentum? If so what tests does he need to undergo to more accurately diagnosis what may be going on with him? Thank you for your time and expertise. XXXXXXX
Brief Answer:
Partial bowels obstruction can be the reason.
Detailed Answer:
Hello!
Thank you for the query.
Omentum is a fatty tissue located in the abdomen. Infarct of it means that it became ischemic. Any ischemia left alone leads to some necrosis. Leaving necrotic tissue in the abdomen gives a great chance for adhesions. And adhesions can be a reason of bowels obstruction (partial) which symptoms can be similar to mentioned by you.
Vomiting, bloating, cramps, occasional lack of gas and stool are typical for this issue.
I do not know how this condition was diagnosed (as it is rare and its hard to distinguish it from the other conditions), but for sure he should have abdominal CT and colonoscopy done. Gastroscopy should be also considered as this does not have to be omentum infarct.
Hope this helps. Feel free to ask further questions.
Regards.
Partial bowels obstruction can be the reason.
Detailed Answer:
Hello!
Thank you for the query.
Omentum is a fatty tissue located in the abdomen. Infarct of it means that it became ischemic. Any ischemia left alone leads to some necrosis. Leaving necrotic tissue in the abdomen gives a great chance for adhesions. And adhesions can be a reason of bowels obstruction (partial) which symptoms can be similar to mentioned by you.
Vomiting, bloating, cramps, occasional lack of gas and stool are typical for this issue.
I do not know how this condition was diagnosed (as it is rare and its hard to distinguish it from the other conditions), but for sure he should have abdominal CT and colonoscopy done. Gastroscopy should be also considered as this does not have to be omentum infarct.
Hope this helps. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your time and expertise. The infarction was dignosed with a CT scan. ER physicians admitted him for observation but said surgery to remove necrotic tissue was not warranted that it would be absorbed and all would be fine. That were puzzled with this condition when there had been no andominal trama to the area. My husband is not on any medication either. He has no trouble with passing stool so the obstruction in the bowel seems iffy to me. He has had a clean colonoscopy in the past 12 months. Thank you again
Brief Answer:
Abdominal CT should be repeated.
Detailed Answer:
Than necrotic tissues presence in the abdomen seems the most probable reason of his symptoms. In such case, another abdominal CT should be done to see the regression/progression of the omentum changes.
Abdominal CT should be repeated.
Detailed Answer:
Than necrotic tissues presence in the abdomen seems the most probable reason of his symptoms. In such case, another abdominal CT should be done to see the regression/progression of the omentum changes.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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