Primary omental torsion mimicking acute appendicitis in a child: a case report

Omental torsion is a rare cause of acute abdomen and an uncommon entity in the pediatric population, often mimicking more common surgical conditions such as acute appendicitis. Preoperative diagnosis remains challenging due to nonspecific clinical and radiological findings. We report the case of an 8-year-old boy who presented with acute right-sided abdominal pain and ultrasound findings initially suggestive of early acute appendicitis, which later proved to be misleading. Diagnostic laparoscopy revealed a hemorrhagic, infarcted omental mass near the hepatic flexure, along with a mildly congested but non-inflamed appendix. Laparoscopic excision of the omental mass and appendectomy were performed. Histopathology confirmed primary omental torsion, without appendicitis. The postoperative course was uneventful. This case highlights the diagnostic difficulty of pediatric omental torsion and supports the role of laparoscopy as an effective diagnostic and therapeutic tool in children presenting with features of an acute abdomen.