Omental torsion is a rare etiology for acute abdominal pain in which the omentum rotates around a fixed point, compromising blood supply. Omental torsion can be primary, occurring in the absence of underlying intraabdominal pathology, or secondary, occurring in the setting of hernias, tumors, cysts, adhesions (surgical scarring), or postinflammatory changes that serve as a nidus for torsion. The etiology of primary omental torsion is not well understood but is associated with central obesity and underlying inflammatory processes. Inguinal hernias are the most common etiology for secondary omental torsion.

Patients will present with acute-onset abdominal pain reflective of an acute surgical abdomen. Typically, pain is located in the right lower quadrant and can be associated with nausea, emesis, or fever.

Middle-aged males are most commonly affected.

If not treated, vascular compromise can lead to infarction.