Left-sided omental torsion secondary to recurrent inguinal hernia in a 24-year-old male: A case report and review of literature.

Abstract

Omental torsion is an infrequent but important cause of acute abdominal pain that can closely resemble appendicitis, diverticulitis, or other intra-abdominal inflammatory conditions. Recognizing it as a potential diagnosis is critical, particularly in patients with risk factors such as recurrent inguinal hernia. We report the case of a 24-year-old male with a history of left-sided direct inguinal hernia repair who presented with sudden-onset lower abdominal pain and vomiting. Imaging revealed herniated greater omentum with the classic "whirl sign" on contrast-enhanced CT. The patient underwent laparoscopic partial omentectomy and hernia repair with an uncomplicated postoperative course. Secondary omental torsion related to inguinal hernia is a rare entity, and left-sided cases in young adults are even less commonly described. This report adds to the limited literature and emphasizes the importance of early imaging and consideration of omental torsion in atypical presentations of acute abdomen. Early recognition of this uncommon condition can prevent diagnostic delays and ensure favorable outcomes. Although rare, patients with primary mesh repairs are at risk, as persistent or recurrent hernia sacs may predispose to secondary omental torsion.