Primary omental torsion: a rare case report and an emergency diagnostic dilemma

Primary omental torsion is an uncommon surgical condition resulting from the rotation of the greater omentum on its long axis, leading to vascular compromise and infarction. Clinically, it presents with nonspecific abdominal pain that mimics more prevalent acute abdominal conditions such as appendicitis, cholecystitis, or diverticulitis, often leading to diagnostic delays. We present a case of a 50-year-old male who experienced persistent, dull, left-sided abdominal pain for two weeks. Imaging with contrast-enhanced computed tomography (CECT) suggested omental torsion, which was confirmed on diagnostic laparoscopy. The affected, necrotic segment of the omentum was resected laparoscopically, and the patient had an uneventful postoperative recovery. Histopathology confirmed haemorrhagic infarction. This case underlines the importance of considering omental torsion in patients with unexplained abdominal pain and highlights the diagnostic value of cross-sectional imaging. Timely surgical intervention prevents complications such as abscess formation or peritonitis and can be effectively managed with laparoscopic techniques.