Rare Cases of Primary Omental Torsion with Gangrene and Laparoscopic Management

Primary omental torsion is an uncommon condition characterized by the twisting of a segment of the omentum along its long axis to the extent that its vascular supply is compromised, resulting in omental gangrene. This condition arises when a mobile, thick segment of the omentum rotates around a fixed proximal point in the absence of any secondary intra-abdominal pathology. Omental torsion can be classified as either primary (idiopathic) or secondary, depending on the presence of an underlying cause. Laparoscopic surgery offers superior diagnostic accuracy for acute abdominal conditions, and the surgical excision of the gangrenous omentum remains the treatment of choice.

We present two rare cases of primary omental torsion: one in an 8-year-old boy and another in a 37-year-old male, both of whom were obese. In these cases, the condition was misdiagnosed preoperatively via sonography as acute appendicitis with perforation peritonitis.