Omental torsion is a rare cause of acute
abdominal pain. It presents with nonspecific symptoms and signs of an
acute abdomen, making it difficult to diagnose preoperatively, because symptoms mimic those caused by other conditions such as
appendicitis,
cholecystitis,
diverticulitis, and other
gynecologic diseases. Computed tomography is an effective and useful method to diagnose and exclude other acute abdominal conditions. Our case presented with sudden right upper
abdominal pain with tenderness, rebound tenderness, mild
fever (37.2℃), increased erythrocyte sedimentation rate (37 mm/hr), increased
high-sensitivity C-reactive protein level (5.97 mg/dL). Computed tomography showed a large, well-circumscribed heterogeneous fatty mass and a 7.3 cm subserosal
myoma. We could not exclude the
myoma as the cause of acute
abdominal pain, so we performed an emergency operation with suspicion of omental torsion or necrotic degeneration of the
myoma. During the operation, we diagnosed primary omental torsion with
infarction and subserosal
myoma without secondary degeneration.