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"textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 55-year-old man with no history of interest was admitted to the emergency department due to symptoms of intense and diffuse abdominal pain, which was more pronounced on the right flank and that started 12<span class="elsevierStyleHsp" style=""></span>h earlier. During the physical examination, the patient presented febricula and abdominal distension, with signs of peritonitis in the lower right quadrant. Laboratory tests revealed only mild leukocytosis. Based on the suspicion of acute appendicitis, an imaging test was requested.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Abdominal computed tomography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) showed an extensive well-delimited fat area causing a mass effect (A). In the upper portion of the coronal slices, we observed a windmill image due to twisting of the feeding vessels (B). In the lower region, the fatty tissue was present in a right inguinal hernia (<span class="elsevierStyleSmallCaps">C</span>). In the volume rendering reconstruction (VR), we observed the findings in 3 dimensions (D). We performed an emergency laparotomy, which found an enlarged and congested omentum due to complete volvulation of the omentum. Faced with the lack of viability, the omentum was completely resected.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The greater omentum can be affected by highly diverse conditions: infections, inflammations, trauma, tumors and vascular disease. The vascular involvement is divided into local infarctions, which are much more common, and complete infarctions, which constitute an exceptional cause of acute abdomen and is produced by twisting of the feeding vessels, typically with multiple twists. The twisting of the omentum can be primary (idiopathic) or secondary when there is a predisposing factor such as a tumor, adhesions and hernias, as in our patient's case.</p></span>"
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