The Omentum: A 'fatty apron' that provides a protective cushion

By: BRADLEY J. FIKES - Staff Writer | Saturday, April 14, 2007 9:30 PM PDT ∞

Call it what you like: Beer belly, protruding gut, spare tire or other creative names. What you're referring to is the visible consequence of the omentum.

Often described as a "fatty apron," the omentum is a sheet of fatty tissue that hangs down in front of the intestines, providing a protective cushion.

Of course, many people have more protection than they need or is healthy for them. The omentum, technically the "greater omentum," is one of the main fat-storage depots in the body. It thickens with accumulating fat, expanding the skin into that well-known shape.

The omentum hangs down, like an apron, from the bottom of the stomach. Its lower edge descends to near the pelvis. It's folded, and the other point of attachment is to the transverse colon, just below the stomach. It varies greatly in thickness, depending on how much fat is stored there.

But the omentum isn't just a passive recipient of fat, a sometimes wayward padding. It's also packed with nutrients and growth-stimulating chemicals, along with stem cells, the "ancestral" cells that turn into various body tissues and organs.

The omentum has germ-fighting cells that migrate to infections in the abdomen. The omentum actually adheres to places of infection, helping to seal them off. For this role, the omentum has been dubbed "the policeman of the abdomen."

The omentum is a handy tool for surgeons, who use it as a kind of biological duct tape. Sections of omentum are grafted onto cut areas or lesions to help them heal. It's been used on the gastrointestinal tract, heart, spinal cord and brain.

The omentum can be also a source of problems. When its blood supply is interrupted, symptoms such as severe pain and tenderness can mimic appendicitis. And of course, an omentum enlarged with fat makes people look unsightly.

One might think it would be easy to get rid of that beer belly by removing the omentum, such as through liposuction. But that would be dangerous. Since the omentum is closely connected to the large intestines, its removal could cause damage. There is also a risk of peritonitis, an infection of the inner abdomen that is extremely serious and can be fatal.

If there's some excess omentum you'd rather not have, the old stand-bys of exercise and diet are the safest way to go. Your omentum will give up the fat naturally and that beer belly will ---- with enough effort ---- flatten out.

Contact staff writer Bradley J. Fikes at (760) 739-6641 or bfikes@nctimes.com.

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