77 Lesser Omental Infarction: A Rare Cause of Intraperitoneal Focal Fat Infarction (IFFI)

Abstract Lesser Omental Infarction is a rare type of Intraperitoneal Focal Fat Infarction (IFFI) caused by the cut-off of blood supply to the fat tissue in the lesser omentum. Patients typically present with symptoms and signs mimicking more serious conditions such as perforated gastric ulcer, pancreatitis, or cholecystitis. This report aims to share insights into the clinical presentation, diagnostic challenges, and management strategies for patients with this condition. A 29-year-old gentleman presented with complaints of upper abdominal pain for two days, radiating to the right side. On abdominal examination, there was a soft but tender right hypochondrium. The patient was admitted with a provisional diagnosis of cholecystitis. Blood investigations were unremarkable, except for an elevated C-reactive protein (CRP). Ultrasound abdomen study was normal and ruled out gallbladder pathology. A CT scan of the abdomen suggested lesser omental infarction secondary to torsion. The patient was managed conservatively with analgesics and discharged after resolution of symptoms. Radiological imaging plays a crucial role in diagnosing lesser omental infarction. If missed, the patient may undergo unnecessary investigations and Interventions. When accurately diagnosed, most cases can be managed conservatively with analgesia. Surgical intervention is rarely required and is reserved for cases where devitalized tissue forms an abscess that does not resolve with conservative management.