All the cases of omental infarcts have been described in the last fifteen years only. These are increasingly recognised as an important cause of the right lower quadrant abdominal pain. Two factors contribute to the increased recognition of this entity. One is the availability of CT scanning technology and the other is epidemic of obesity.

Commonly the severity of the pain is disproportionate to the clinical signs. It is almost always located in the right iliac fossa in close association to the ascending colon and hepatic flexure. CT imaging is highly specific for omental infarcts. A cake like high attenuation fat density mass centered in the omentum is typically observed. If the adjacent bowel wall is thickened it is very minimal and pathology is primarily located in the omentum.

Omental infarcts are classified as primary and secondary types. If an aetiology is identified it is called as secondary and if no cause could be found it is called as primary.

Omental infarcts and epiploic appendagitis may have similar appearance, but omental infarct is a right sided pathology where as epiploic appendagitis is a left sided pathology. When it is not possible to differentiate an umbrella term intrabdominal focal fat inflammation can be used with no harm.

The importance in recognising these entities is to prevent unnecessary surgery. Most of the cases of omental infarcts get well with conservative management but when there is detoriation in the patient condition surgery and necrosectomy can be performed with out hesitation. In this patient there is nonrotation of the small bowel with midgut volvulus and this can be precipitating factor for omental infarct 

Ref:

1.       http://radiologycme.stanford.edu/2008mdct/handouts/wed/1105-Federle-Omental_Infarction_.pdf

2.       http://www.m-hikari.com/cems/cems2013/cems5-8-2013/concannonCEMS5-8-2013.pdf

3.       http://www.ajronline.org/doi/full/10.2214/ajr.178.6.1781537

4.       http://radiographics.highwire.org/content/24/3/703.full