Minimally Invasive Surgical Resolution of Omental Infarction: A Case of Refractory Abdominal Pain.

Omental infarction is a rare cause of acute abdomen that frequently mimics more common surgical pathologies, often complicating the initial clinical assessment. We describe the case of a 35-year-old male patient with a history of hypertension and human immunodeficiency virus (HIV) infection who presented with severe, persistent abdominal pain in the right flank that was refractory to medical management. Notably, an initial computed tomography (CT) scan was negative, highlighting the diagnostic challenge of early presentation. Due to clinical persistence, a repeat CT scan performed 48 hours later was instrumental in confirming signs of omental infarction. The patient underwent an exploratory laparoscopy and resection of the necrotic omental segment, which confirmed the diagnosis of segmental omental infarction. Postoperatively, the patient showed favorable progress with rapid pain relief and was discharged two days after surgery. No further complications occurred during the follow-up period. This case underscores that while CT is essential for diagnosis, the clinical evolution dictates management, and an individualized laparoscopic approach allows for definitive confirmation and treatment, facilitating a quick recovery and potentially preventing long-term complications.