WOFAPS 2025 8th World Congress of Pediatric Surgery

Yusuf Polat ¹, Muhammed Hamidullah Çakmak ¹, Gül İlayda Sarar ², Özlem Balcı ¹

¹ University of Health Science, Zeynep Kamil Maternity and Children’s Diseases Health Training and Research Center, Department of Pediatric Surgery, İstanbul
² Agri State Hospital Pediatric Surgery Clinics

Introduction: Omental cysts are rare intra-abdominal pathologies in children and are usually asymptomatic or present with complaints such as abdominal pain and distension. Infected omental cysts are much rarer. Herein we are presenting an infected and ruptured giant omental cyst that manifested with sepsis and intestinal obstruction in an infant.

Case Presentation: A 1-year-old girl presented with, abdominal pain and distension, vomiting, and fever for the last 3 days. Physical examination revealed abdominal distension and tenderness. She had extremely elevated CRP levels (355 mg/L). Pathological gas-fluid levels were detected in the abdominal X-ray examination, and ultrasound showed a heterogeneous fluid collection up to 70 mm in thickness. Urgent laparotomy was performed for her acute abdomen, suspicious for perforated appendicitis. During laparotomy, a ruptured bilobed omental cystic mass with 20 cm diameter at the upper quadrant originating from the greater omentum. The cyst was totally excised and the abdominal cavity was cleaned. Her postoperative course was uneventful and discharged home on the 5^th day of surgery. The pathology confirmed the diagnosis of an omental cyst.

Conclusions: Omental cysts are rare abdominal pathologies, often asymptomatic, but may cause life-threatening complications such as intestinal obstruction or infection when it gets huge diameters. Infected and ruptured omental cysts are extremely rare and may cause acute abdomen as observed in our case presented.