Omental cyst torsion

Introduction

Introduction

Omental cyst torsion is a clinical manifestation of omental cysts. Once the omental cyst is confirmed, it should be treated surgically. It is not recommended to use B-ultrasound or CT-guided aspiration. Single cysts should be completely removed. When the cyst is dense and inseparable from the stomach and intestine, it should be removed together with the affected part in principle, but the giant lymphatic cyst which is widely adhered to the small intestine, in order to avoid a large number of small intestine resection, the cyst can be completely removed, and the residual part is Intervals should be cut off as much as possible to make them open, and then the residual cyst wall should be rubbed with 3% iodine to destroy the inner membrane.

Pathogen

Cause

The cause of retinal cyst torsion: retinal cyst torsion is suffering from omental cysts.

Examine

an examination

Related inspection

Duodenal barium meal angiography

Diagnosis of omental cyst torsion:

Omental cysts are rare diseases that account for only about 5% of omental diseases, and their incidence is much lower than that of mesenteric cysts. The ratio of the two is about 1:5. The omental cyst is located between the two membranes of the omentum and is divided into true cysts and pseudocysts. The clinical manifestations vary depending on the size of the cyst and the presence or absence of complications, which are grouped into 4 types:

1. Abdominal block type abdomen clearly touches the cystic mass with no tenderness and large mobility, which may be accompanied by abdominal pain or falling pain.

2. The pseudo-abdominal type is only seen in the giant omental cyst, the abdomen is gradually enlarged, the whole abdomen is bulging, and the mass cannot be clearly touched. The liquid wave tremor is obvious, but there is no mobile dullness.

3. The occult type is mostly a small cyst, which is accidentally discovered during abdominal surgery.

4. Acute abdomen cysts complicated by torsion, internal hemorrhage, ulceration or secondary infection can cause acute abdominal pain and peritoneal irritation. After cystic hemorrhage, the cyst is rapidly enlarged and susceptible to infection. Because most cysts are multi-atrial, infection is not easy to control, patients with high fever or long-term low fever, intermittent abdominal pain, lack of energy, poor appetite, weight loss, anemia and other symptoms of consumption of poisoning, clinically similar to tuberculous peritonitis. Very easy to misdiagnose. Cyst rupture is manifested as sudden increase in abdominal pressure after external force hitting the abdomen or various causes of intra-abdominal pressure. Abdominal severe abdominal pain, abdominal distension, accompanied by obvious anemia, obvious blood or even inflammatory peritonitis, often like acute abdomen. Cyst torsion occurs in the middle and small cysts of the free part of the greater omentum. The range of activity is wide. Due to the reversal of cysts due to gravity, the clinical manifestations are persistent abdominal pain with paroxysmal aggravation, accompanied by nausea and vomiting. Abdominal masses are found after physical examination. It was confirmed that the omental cyst was twisted.

Diagnosis

Differential diagnosis

Differential diagnosis of retinal cyst torsion:

The disease lacks characteristic symptoms and signs, so the clinical diagnosis is difficult. The correct diagnosis rate of preoperative diagnosis is only 13% to 57%. It should be clinically associated with tuberculous peritonitis, mesenteric lymphadenitis, mesenteric cyst, and echinococcosis cyst. Identification.

1. Tuberculous peritonitis This disease is mainly caused by childhood and young adults. It is common in women. It has subacute and chronic manifestations in clinical practice. Most of them have low fever, infirmity, weight loss, anemia, night sweats, diarrhea, etc. Symptoms of poisoning, common ascites, positive mobile dullness, often mild tenderness and muscle tension, showing a typical "dough-like" touch, the tuberculin test has diagnostic value.

2. Non-specific mesenteric lymphadenitis This disease occurs in preschool and school-age children, more boys, children often have a history of recent upper respiratory tract infection, the typical symptoms are umbilical, right lower abdomen and right abdominal cramps, pain Children in the intermittent period felt good and the white blood cell count increased.

3. Echinococcus granulosus cysts The disease is most common in pastoral areas, males, clinical manifestations have no differential significance, but by sedimentation test, complement binding test Casoni test can be identified.

4. Mesenteric cysts Mesenteric cysts and omental cysts are difficult to identify clinically. Selective superior mesenteric artery angiography is important. Mesenteric cysts can push the mesenteric vessels up or apart.

Diagnosis: Omental cyst is a rare disease, accounting for only about 5% of omental disease, and its incidence is much lower than mesenteric cyst, the ratio of the two is about 1:5. The omental cyst is located between the two membranes of the omentum and is divided into true cysts and pseudocysts. The clinical manifestations vary depending on the size of the cyst and the presence or absence of complications, which are grouped into 4 types:

1. Abdominal block type abdomen clearly touches the cystic mass with no tenderness and large mobility, which may be accompanied by abdominal pain or falling pain.

2. The pseudo-abdominal type is only seen in the giant omental cyst, the abdomen is gradually enlarged, the whole abdomen is bulging, and the mass cannot be clearly touched. The liquid wave tremor is obvious, but there is no mobile dullness.

3. The occult type is mostly a small cyst, which is accidentally discovered during abdominal surgery.

4. Acute abdomen cysts complicated by torsion, internal hemorrhage, ulceration or secondary infection can cause acute abdominal pain and peritoneal irritation. After cystic hemorrhage, the cyst is rapidly enlarged and susceptible to infection. Because most cysts are multi-atrial, infection is not easy to control, patients with high fever or long-term low fever, intermittent abdominal pain, lack of energy, poor appetite, weight loss, anemia and other symptoms of consumption of poisoning, clinically similar to tuberculous peritonitis. Very easy to misdiagnose. Cyst rupture is manifested as sudden increase in abdominal pressure after external force hitting the abdomen or various causes of intra-abdominal pressure. Abdominal severe abdominal pain, abdominal distension, accompanied by obvious anemia, obvious blood or even inflammatory peritonitis, often like acute abdomen. Cyst torsion occurs in the middle and small cysts of the free part of the greater omentum. The range of activity is wide. Due to the reversal of cysts due to gravity, the clinical manifestations are persistent abdominal pain with paroxysmal aggravation, accompanied by nausea and vomiting. Abdominal masses are found after physical examination. It was confirmed that the omental cyst was twisted.