[Diagnostic imaging of idiopathic segmental infarct of the greater omentum. Diagnostic and physiopathologic considerations]. / Imagerie des infarctus segmentaires idiopathiques du grand épiploon. Apport diagnostique et physiopathologique.

Primary infarction of the greater omentum is a rare cause of acute abdominal syndrome. Rate of occurrence may nevertheless be underestimated. We report a series of six cases observed over a 30-month period with US and CT imaging. We assessed early signs and their course. CT-scans depicted fatty oval-shaped masses below the right anterior or anterolateral parietal wall, associated with a thickening of the anterior parietal peritoneum, explaining symptom pathogenesis. Torsion can be identified, but has no specific impact on prognosis. Follow-up CT scan may evidence spontaneous, but sometimes slow, resolution.

[Radiologic aspects of infarction of the appendix epiploica]. / Aspects radiologiques des infarctus d'appendices épiploïques.

Clinical, US, CT and MR findings were reviewed in 5 patients with primary epiploic appendagitis (3 men, 2 women, mean age 38 years, age range 29-62 years) seen between December 1994 and December 1997. Diagnosis was reached in all cases with CT, with US in 3 and with MR in 1. Follow-up CT was performed in 2 cases and clinical follow-up in 4. One patient underwent surgery. Initial US, CT or MR examinations revealed a fatty oval-shaped nodule located anteriorly or anterolaterally to the left colon. The greater diameter ranged from 20 to 30 mm. Perinodular lesions with strands of periappendicular fat and thickened parietal peritoneum were visualized in all cases without any other inflammatory process in the abdomen. Symptoms resolved within 4 days in all patients. Signs of fatty inflammatory processes resolved in the 2 patients who had follow-up CTs. Primary epiploic appendagitis has characteristic US, CT and MR features which help guide medical treatment.