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Spontaneous And Rapid Healing Of Massive Symptomatic Postoperative Right-sided Infarction Of The Greater Omentum

Coulier, B. 2018Colorectal cancer

Coulier B. (2018). Spontaneous and rapid healing of massive symptomatic postoperative right-sided infarction of the greater omentum. Diagnostic and interventional imaging, 99(5), 339–340. https://doi.org/10.1016/j.diii.2017.12.002

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Case Details

Disease Location

Greater omentum

Personal Characteristics

76-year-old man

Clinical Characteristics

Presented with pain in the right upper quadrant 13 days after an uncomplicated celioscopic resection of a t2n0m0 right colon adenocarcinoma. C-reactive protein serum level was elevated. CT revealed a 10.5 × 7.6 × 7.2 cm, ovoid lipomatous mass with central collections in the right upper quadrant consistent with massive infarction of the greater omentum

Remission Characteristics

Symptoms disappeared, and c-reactive protein returned to 17mg/l eight days later. Three weeks later, CT revealed substantial volume reduction of the mass. The central fluid collections had disappeared. The mass was now distinctly surrounded by a two-layer enhancing pseudocapsule. Three months later the lesion had nearly completely resolved and 6 months later the lesion was not visible any more on CT.

Treatment & Mechanisms

Proposed Remission Mechanisms

Complete avulsion of the infarcted omental segment from its insertion, as suggested by the presence of a complete peripheral pseudo capsule, has led to a strong, resorptive foreign body reaction.