• Title, Summary, Keyword: Omental

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Surgical Treatment of Postoperative Leakage with Pedicled Omental Flap (유경성 대망이식편을 이용한 술후 식도천공 치험1례)

  • Im, Chang-Yeong;Kim, Yo-Han;Yu, Hoe-Seong
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.26 no.4
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    • pp.325-328
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    • 1993
  • The pedicled omental flap has been used for treatment of various kind of complications in thoraxcic surgery. Its property of promoting neovascularization , immunilogic properties that limiting the spread of infection, providing soft tissue coverage are very effective in treatment esophageal fistulas. Also, congenital broncho-esophageal fistula [ BEF ] is a rare disease entity which was reported about 100 cases around the world. We experienced 27 years old female patient with Braimbridge type I congenital BEF. We performed division of BEF using stapler and pericardial patch coverage of esophageal side with concomittent left lower lobectomy. This patient was complicated with postoperative esophageal leakage with empyema thoracis. We have successfully managed these problems with re-thoracotomy and re-closure of esophageal fistula using Right Gastroepiploic Artery based pedicled omental flap wrapping around the esophageal anastomosis site. It is felt that pedicled omental flap is a very effective method to manage esophageal complication such as postoperative esophageal leakage.

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Omental Free Shaped Flap Reinforcement on Anastomosis and Dissected Area (OFFROAD) Following Gastrectomy

  • Han, WonHo;Park, KyongLin;Kim, Deok-Hee;Kim, Young-Woo
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.180-182
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    • 2018
  • The frequency of anastomotic leakage after gastrectomy is reported to be 0.9~8%. To reduce deleterious outcomes of anastomotic leakage, we devised the "Omental Free-shaped Flap Reinforcement On Anastomosis and Dissected area" procedure not only to prevent fatal complications following anastomotic leakage but also to promote vascularity of anastomoses and other expected oncological benefits. This video illustrates the surgical procedure following a totally laparoscopic distal gastrectomy. After completion of the anastomosis, the remaining omentum was mobilized upward and divided into two sections. We placed the left section of the omental flap under the anastomosis between the stomach and pancreas. Finally, we grasped and curved the tip of the section to cover the anastomosis from behind, and we placed the right section of the omental flap above the anastomosis. These two sections were approximated with clips to the anterior wall of the stomach. The patient was discharged without complications.

Primary Omental Torsion (대망염전)

  • Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.68-70
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    • 1997
  • One case of primary omental torsion in a 10 year-old, 43 kg boy is presented. He presented with a history of acute, continuous pain in the upper abdomen, aggravated by changes of position. Physical examination of his abdomen showed board-like rigidity. tenderness and rebound tenderness over the entire abdomen. The preoperative diagnosis was perforated peptic ulcer. Exploratory laparatomy revealed torsion of the greater omentum. The torsed omentum was excised and the outcome was good. Omental torsion is a rare surgical condition and is difficult to diagnose prior to operation. Therefore, in case of negative exploration for acute abdomen, the omentum should be included among the organs examined. In addition, careful search for an inflammatory focus should be made, because secondary omental torsion with intraabdominal sepsis is much more common than primary torsion.

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Mesenteric and Omental Cysts in Infancy and Childhood (영아 및 소아기의 장간막 및 대망낭종)

  • Lee, Sang-Kyu;Park, Dong-Weon;Chang, Soo-Il
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.61-66
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    • 1998
  • Mesenteric and omental cysts are rare lesions in childhood. These cysts are morphologically and pathologically similar to lymphangiomas that occur in other parts of the body. From 1980 to 1997, 8 children were diagnosed and treated for mesenteric or omental cysts. Their ages ranged from 18 days to 6 years. There were 5 boys and 3 girls. The main presenting symptom was abdominal pain. Operative procedures were complete cysts excision, complete excision with intestinal resection, or complete excision with intestinal resection and colostomy. Accurate preoperative diagnosis was possible with the current ultrasonographic imaging techniques. Complete excision of the lesion was possible in all patients and results were excellent.

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Omental Infarction Following Laparoscopy-assisted Gastrectomy (LAG) for Gastric Cancer (위암 환자의 복강경 위절제술 후 발생한 그물막 경색의 임상적 의의)

  • Kim, Min-Chan;Jung, Ghap-Joon;Oh, Jong-Young
    • Journal of Gastric Cancer
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    • v.10 no.1
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    • pp.13-18
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    • 2010
  • Purpose: Omental infarction (OI) following laparoscopy-assisted gastrectomy (LAG) for gastric cancer could become more common in the future because the indications for LAG are expected to expand. The aim of this study was to determine the clinical characteristics of OI following LAG. Materials and Methods: Three hundred ninety patients who underwent LAG for T1 or T2 gastric cancer from April 2003 to November 2007 were enrolled. OI was diagnosed by two radiologists using the patients' abdominal 16 row-detector CT scans. The clinicopathologic characteristics were retrospectively evaluated in the omental infarction (OI) group and the non-omental infarction (non-OI) group using the gastric cancer database of Dong-A University Medical Center and the medical record. Results: Nine omental infarctions (2.3%) of 390 LAGs were diagnosed. All the OIs could be discriminated from omental metastasis on the initial or follow up CT images. The location of the omental infarctions was on the epigastrium in 3 patients and in the left upper quadrant in 3 patients. The mean size of the OIs was 4.1 cm. Most patients with OI had no signs or symptoms. The body mass index of the OI group was higher than that of the non-OI group (P=0230), and OI was more common in patients who underwent total gastrectomy than in the patients who underwent subtotal gastrectomy (P=0.0011). Conclusion: Laparoscopy-assisted gastrectomy (LAG) with partial omentectomy for gastric cancer can be a cause of secondary OI. Omental infarction after LAG has different clinical characteristics and CT findings that those of other omental infarctions or postoperative omental metastases. Further multicenter study will be needed to evaluate in detail the clinical features of omental infarction after LAG.

Clinical Features and Outcomes of Primary Omental Lipoma in a Dog

  • Song, Doo-Won;Lee, Ga-Won;Kang, Min-Hee;Kim, Hwi-Yool;Eom, Ki-Dong;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.36 no.5
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    • pp.271-273
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    • 2019
  • A 12-year-old intact male Cocker spaniel dog was presented for evaluation of lethargy and abdominal distension. Clinical examination revealed a round, palpable mass in the middle of the abdomen. Abdominal computed tomography showed a round soft tissue mass ($width{\times}height{\times}length$, $25{\times}13{\times}15cm^3$) without regional invasion and distant metastasis. Cytologic evaluation of the mass revealed adipose tissue-derived cells having vacuolated cytoplasm, indistinct borders, large nucleus and ropy chromatin pattern with variable sized lipid droplets. Complete surgical resection of the mass was performed and the mass was histopathologically diagnosed as primary omental lipoma. The dog has been recovered well without any additional clinical signs, and there was no relapse over the 8 months follow-up period. The clinical features and prognosis of the dog with primary omental adipocytic tumors have been described in this report.

A Case of an Omental Infarction in a Child (우상복부 통증을 주소로 내원한 10세 남아의 대망 경색 1예)

  • Park, Jae-Yong;Yu, Ri-Ta Miyoung;Kim, Do-Joong;Yoo, Jee-Hyoung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.70-74
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    • 2009
  • An omental infarctions is an uncommon cause of an acute abdomen and a rare entity in children. The etiology is still unclear and the symptoms mimic acute appendicitis. We recently encountered a case of a 10-year-old boy who had a previous surgical history of a manual reduction for intussusception. He complained of abdominal pain and right upper quadrant tenderness without fever or anorexia. An abdominal ultrasonography suggested an omental infarction and computed tomography confirmed the diagnosis. Conservative management was adopted with a rapid and uneventful recovery. Non-operative treatment is a safe and effective treatment of choice for omental infarction.

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Usefulness of Omental Flap for Various Soft Tissue Reconstruction (다양한 연부조직 재건에서의 대망피판의 유용성)

  • Lee, Hwa Seob;Park, Sae Jung;Ryu, Hyung Ho;Suh, Man Soo;Lee, Dong Gul;Chung, Ho Yun;Park, Jae Woo;Cho, Byung Chae
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.428-434
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    • 2005
  • Extensive and complicated defects on the body call for an omnipotent tool for a perfect reconstruction. Flaps derived from the omentum has many advantages over the conventional flaps. From 1999 to 2004, Omental flaps were applied for various soft tissue reconstructions. Among total 20 total 7 cases were for immediate reconstruction, 2 cases for chronic infection, 3 cases for simultaneous reconstruction of two defects, 4 cases for functional joint reconstruction and 4 cases were for flow- through revascularization. Among these cases, 3 cases were operated with minimal incision harvest technique. There were no complete flap failures, partial necrosis of the distal parts were noted on three cases. The omental flap is indicated on a large contaminated defect reconstruction due to its large size, well-vascularized, and malleable properties. The omental flap provides several additional advantages over other flaps, which are; the availability of the one staged simultaneous reconstruction of two defects with one flap, providing gliding function for the joint motion, and a flow-through characteristics with long vascular pedicle. But there are some serious shortcomings, including a long abdominal scar and intraabdominal problems. However, these are rare and can be minimized with our minimal incision technique. Due to its unique characteristics. the omentum is one of the ideal tissues for the reconstruction of the complicated soft tissue defects due to its unique characteristics.

Torsion of Omental Cystic Teratoma in a Child: - A Case Report - (소아에서 발생된 대망 낭성 기형종의 염전 1예)

  • Jeong, Yeon-Jun;Yu, Hee-Chul;Cho, Baik-Hwan;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.64-67
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    • 2000
  • Although intraperitoneal teratomas are rare, teratomas of the greater omentuma are seldom reported. A single case of omental teratoma with torsion in a 26-month-old girl is reported. The patient presented with abdominal pain and a palpable mass. Ultrasonography and CT of the abdomen showed a large cystic mass with a non homgenious solid component composed of fat and calcification. The lesion was surgically excised. Pathology revealed a mature omental teratoma. The hospital course was uneventful.

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Cellularity of Adipose Tissue Obtained from Different Sex and Growth Stages of Hanwoo Cattle and Sheep

  • Lee, H.J.;Lee, S.C.;Kim, D.W.;Park, J.G.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.2
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    • pp.155-160
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    • 2000
  • In order to understand the effects of sex or age on cellular characteristics of adipocytes from Hanwoo and sheep, samples were obtained from omental, subcutaneous, intermuscular and intramuscular adipose tissue depots of bulls, steers, heifers and cows in Hanwoo, and perirenal, omental and subcutaneous adipose tissues of fetal lambs, suckling lambs and wethers in sheep. In case of Hanwoo, mean diameter, surface area and volume of adipocytes from each depot were obtained by multisizer II (Coulter Co., UK). Osmium-fixed adipocytes were sized and counted using $560{\mu}m$ aperture. For samples obtained from sheep, cellularity was measured by using microscope and MCV program of Texas Instrument. Bulls had less subcutaneous and kidney fat than steers even though their slaughter and carcass weight were heavier. The amounts of fat from cows were greater in subcutaneous, kidney and internal organs than heifers. Steers had larger adipocytes in subcutaneous, intermuscular and intramuscular adipose tissues than bulls, although the differences were significant only for the subcutaneous adipose tissue depots. Adipocytes appeared to be largest in omental and smallest in intramuscular adipose tissue, although there were no significant differences among tissues. In a comparison of heifers and cows, significant site effects (p<0.05) were shown in adipocyte diameter, surface area and volume, and adipocyte appeared to be largest in omental tissue. Statistical difference (p<0.05) was only shown in cell volume of intramuscular tissue which was higher in cow than heifer. Intramuscular adipose tissue tended to have relatively greater numbers of cells per gram tissue and reflect lesser maturity of intramuscular adipose tissue relative to other adipose tissues. In sheep, regardless of adipose tissue depots, wethers had the greater adipocyte diameters than those at any other growth stage of sheep. Within adipose depots, the ranking of cell size was the greatest in the omental tissue of wether and the lowest in the renal and subcutaneous adipose tissue depots of fetal lamb. The cell size of adipocyte became larger with age, especially from fetal to suckling lamb due to a rapid hypertrophy of both perirenal and subcutaneous adipocytes during the suckling period.