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      Secondary Omental Infarction Related to Open and Laparoscopic-Assisted Distal Gastrectomy: Report of Two Cases

      case-report

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          Abstract

          Omental infarction occurring after open and laparoscopic-assisted distal gastrectomy with partial omentectomy for gastric cancer was a very rare disease in the past, but its incidence has increased as more partial omentectomies are now being performed. But there are few case reports or radiologic studies on its increasing incidence. It is necessary to differentiate omental infarction from carcinomatosis peritonei, since both have similar imaging findings. In this report, we describe two cases of omental infarction; each occurred after open and laparoscopic-assisted distal gastrectomy in early gastric cancer patients. Partial omentectomy was performed in both cases. Omental infarction following distal gastrectomy with partial omentectomy can be discriminated from carcinomatosis peritonei by comparing with different initial and follow up CT findings.

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          Japanese Classification of Gastric Carcinoma - 2nd English Edition -

          Japanese Gastric Cancer Association (1998)
          PREFACE: The first edition of the General Rules for Gastric Cancer Study was published by the Japanese Research Society for Gastric Cancer (JRSGC) in 1963. The first English edition [1] was based on the 12th Japanese edition and was published in 1995. In 1997, the JRSGC was transformed into the Japanese Gastric Cancer Association and this new association has maintained its commitment to the concept of the Japanese Classification. This second English edition was based on the 13th Japanese edition [2].The aim of this classification is to provide a common language for the clinical and pathological description of gastric cancer and thereby contribute to continued research and improvements in treatment and diagnosis.
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            Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs.

            My-Linh T. Nguyen, S Lee, Brent B Wolfe … (2001)
            To compare outcomes, quality of life (QOL), and costs of laparoscopic and open gastric bypass (GBP). Laparoscopic GBP has been reported to be a safe and effective approach for the treatment of morbid obesity. The authors performed a prospective randomized trial to compare outcomes, QOL, and costs of laparoscopic GBP with those of open GBP. From May 1999 to March 2001, 155 patients with a body mass index (BMI) of 40 to 60 kg/m2 were randomly assigned to undergo laparoscopic (n = 79) or open (n = 76) GBP. The two groups were similar in age, sex ratio, mean BMI, and comorbidities. Main outcome measures included operative time, estimated blood loss, length of hospital stay, operative complications, percentage of excess body weight loss, and time to return to activities of daily living and work. Changes in QOL were assessed using the SF-36 Health Survey and the bariatric analysis of reporting outcome system (BAROS). Operative and hospital costs of the two operations were also compared. There were no deaths in either group. Mean operative time was longer for laparoscopic GBP than for open GBP, but operative blood loss was less. Two (2.5%) of the 79 patients in the laparoscopic group required conversion to laparotomy. Median length of hospital stay was shorter for laparoscopic GBP patients (3 vs 4 days). The rate of postoperative anastomotic leak was similar between groups. Wound-related complications such as infection (10.5 vs 1.3%) and incisional hernia (7.9 vs 0%) were more common after open GBP; late anastomotic stricture was less frequent after open GBP (2.6 vs 11.4%). Time to return to activities of daily living and work were shorter after laparoscopic GBP than after open GBP. Weight loss at 1 year was similar between groups. Preoperative SF-36 scores were similar between groups; however, at 1 month after surgery, laparoscopic patients had better physical conditioning, social functioning, general health, and less body pain than open GBP patients. At 6 months, the BAROS outcome was classified as good or better in 97% of laparoscopic GBP patients compared with 82% of open GBP patients. Operative costs were higher for laparoscopic GBP patients, but hospital costs were lower. Laparoscopic GBP is a safe and cost-effective alternative to open GBP. Despite a longer operative time, patients undergoing laparoscopic GBP benefited from less blood loss, a shorter hospital stay, and faster convalescence. Laparoscopic GBP patients had comparable weight loss at 1 year but a more rapid improvement in QOL than open GBP patients. The higher initial operative costs for laparoscopic GBP were adequately offset by the lower hospital costs.
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              Right-sided segmental infarction of the omentum: clinical, US, and CT findings.

              Julien Puylaert (1992)
              Clinical, ultrasound (US), and computed tomographic (CT) findings at hospital admission and follow-up were retrospectively studied in seven patients with right-sided segmental infarction of the omentum. In all patients, the presumptive clinical diagnosis was appendicitis, although in three patients cholecystitis and pyelitis were also considered. US revealed an ovoid or cakelike, moderately hyperechoic, noncompressible lesion adherent to the peritoneum and located at the level of the umbilicus, anterolateral to the right half of the colon. On CT scans, a corresponding, better defined area of fat interspersed with hyperattenuating streaks was found. No abnormality of bowel or appendix was seen. The clinical symptoms and abnormalities on US scans gradually disappeared in all patients. Because no patient underwent surgery, no histologic proof was obtained. In all patients, however, the clinical, US, and CT findings were similar and consistent. They corresponded to the abnormality called right-sided segmental omental infarction in the surgery and radiology literature and enabled exclusion of appendicitis, thus preventing unnecessary surgery.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Radiol
                Journal ID (publisher-id): KJR
                Title: Korean Journal of Radiology
                Publisher: The Korean Society of Radiology
                ISSN (Print): 1229-6929
                ISSN (Electronic): 2005-8330
                Publication date (Print): Nov-Dec 2011
                Publication date (Electronic): 27 September 2011
                Volume: 12
                Issue: 6
                Pages: 757-760
                Affiliations
                [1 ]Department of Radiology, St. Mary's Hospital, The Catholic University of Korea, Seoul 150-713, Korea.
                [2 ]Department of General Surgery, St. Mary's Hospital, The Catholic University of Korea, Seoul 150-713, Korea.
                Author notes
                Corresponding author: Dong Jin Chung, MD, Department of Radiology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 62 Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea. Tel: (822) 3779-1327, Fax: (822) 783-5288, bookdoo7@ 123456chollian.net
                Article
                DOI: 10.3348/kjr.2011.12.6.757
                PMC ID: 3194783
                PubMed ID: 22043161
                SO-VID: 8ee893c5-d3e2-4d35-9b0f-82a38fee1b17
                Copyright © Copyright © 2011 The Korean Society of Radiology
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 March 2011
                Date accepted : 03 May 2011
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: ct,gastrectomy,omental infarction,carcinomatosis peritonei
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: ct, gastrectomy, omental infarction, carcinomatosis peritonei

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