Infarto segmentario idiopático del epiplón mayor, resuelto por cirugía endoscópica. Reporte de un caso

Introduccion. El infarto segmentario idiopatico primario del epiplon mayor se presenta de manera ocasional en la etapa pediatrica, predomina en ninos con sobrepeso y se confunde con apendicitis aguda. Caso clinico. Paciente masculino de 6 anos de edad con dolor abdominal y febricula de 36 horas de evolucion. Peso de 25 kg (p-90), talla 115 cm (p-50), discreta deshidratacion, dolor importante en fosa iliaca y flanco derechos asi como irritacion peritoneal localizada. La biometria hematica mostro leve leucocitosis, y la radiografia simple de abdomen reaccion peritoneal. Durante la cirugia endoscopica se encontro un segmento del epiplon infartado, el cual se ligo, se reseco y se extrajo. La evolucion fue satisfactoria. Conclusion. La cirugia endoscopica proporciona una excelente exposicion para el diagnostico y tratamiento del infarto del epiplon mayor.(AU) Introduction. The primary idiopathic segmentary infarction of the great omentum is rarely found in the pediatric age group; it is predominant in overweight children and it is mistaken for acute appendicitis. Case report. Six year old masculine patient presented abdominal pain for 36 hours associated with low grade fever; he weighed 25 kg (p-90), his height was 115 cm (p-50), on physical examination he showed slightly dried oral mucosa, pain on lower right quadrant with peritoneal irritation signs. The white blood count showed slight leukocitocys and the abdomen radiograph showed inflammation and peritoneal irritation. Endoscopic surgery was done and an infarcted segment of greater omentum was found, it was ligated, resected and extracted. Clinical evolution was satisfactory. Conclusion. Endoscopic surgery gives us an excellent resource for diagnosis and treatment of this pathology.(AU)