From the Research
Omental infarction is typically treated conservatively with pain management and observation in most cases, as this approach prioritizes minimizing morbidity, mortality, and optimizing quality of life. The recommended approach begins with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (600-800 mg three times daily) or naproxen (500 mg twice daily) for pain control, along with rest and limited physical activity until symptoms improve, as supported by the most recent study 1. Most patients recover within 1-2 weeks with this conservative management. Adequate hydration should be maintained, and patients should be monitored for symptom improvement. In cases with severe pain, opioid analgesics may be temporarily needed.
Key Considerations
- Surgical intervention through laparoscopy or laparotomy with resection of the affected omental segment is reserved for patients who fail conservative management, have worsening symptoms, develop complications like abscess formation, or when the diagnosis remains uncertain, as noted in 2.
- The conservative approach is preferred because omental infarction is self-limiting, and the infarcted tissue will eventually be reabsorbed by the body, highlighting the importance of avoiding unnecessary surgical risks unless absolutely necessary, as discussed in 3 and 4.
- Follow-up imaging is not routinely required but may be considered if symptoms persist beyond the expected recovery period, emphasizing the need for personalized care based on patient response to initial treatment, as suggested by 5 and 1.
Treatment Overview
- Conservative management is the first line of treatment, focusing on symptom control and supportive care.
- Surgical options are considered for specific indications, such as failure of conservative management or development of complications.
- The choice between conservative and surgical management should be based on individual patient factors, including clinical presentation, response to initial treatment, and presence of complications, as outlined in the studies 3, 4, 2, 5, 1.