Incidentally Discovered Omental Infarction in a Patient With Right Upper Quadrant Abdominal Pain: A Case Report

Omental infarction is a rare and often under-recognized cause of acute abdominal pain. Its clinical presentation varies by location and may mimic other intra-abdominal pathologies. Small infarctions, such as the one described in this case, may not be easily detectable on imaging and can be overlooked without surgical exploration. We present the case of a multiparous woman in her mid-30s who presented to the emergency department with acute-on-chronic epigastric pain. She was taken to the operating room for presumed biliary pathology. Intraoperatively, a twisted segment of omentum adherent to the peritoneum was incidentally identified, and the patient underwent omental resection with adhesiolysis. Histopathologic evaluation revealed fat necrosis suggestive of ischemia secondary to prior torsion. This case highlights the occult nature of small omental infarctions and underscores the importance of considering this entity in the differential diagnosis during the workup of acute abdominal pain.