Epiploic appendagitis: a non-surgical cause of acute abdomen (original) (raw)
Related papers
Acute epiploic appendagitis: A rare cause of acute abdomen and a diagnostic dilemma
Journal of Family and Community Medicine, 2016
Acute epiploic appendagitis is a relatively rare cause of lower abdominal pain that clinically mimics other acute abdomen conditions that require surgery such as acute diverticulitis or appendicitis. Here, we report a case of a 50-year-old lady who presented with an unusual lower abdominal pain. Awareness of such a clinical condition with its characteristic imaging findings is important to avoid costly hospitalization, unnecessary antibiotic courses, and the morbidity and mortality associated with surgical procedures.
Acute Epiploic Appendagitis: A Nonsurgical Abdominal Pain
Case Reports in Emergency Medicine
Epiploic appendagitis is a relatively rare disease characterized by an inflammation of fat-filled serosal outpouchings of the large intestine, called epiploic appendices. Diagnosis of epiploic appendagitis is made challenging by the lack of pathognomonic clinical features and should therefore be considered as a potential diagnosis by exclusion first of all with appendicitis or diverticulitis which are the most important causes of lower abdominal pain. Currently, with the increasing use of ultrasound and computed tomography in the evaluation of acute abdominal pain, epiploic appendagitis can be diagnosed by characteristic diagnostic imaging features. We present a case of epiploic appendagitis with objective of increasing knowledge of this disease and its diagnostic imaging findings, in order to reduce harmful and unnecessary surgical interventions.
Epiploic Appendagitis: A Commonly Overlooked Differential of Acute Abdominal Pain
Cureus, 2021
Epiploic appendagitis is an unusual and very commonly overlooked source of acute abdominal pain. Its incidence is highest in middle-aged obese males. It presents clinically as a focal lower quadrant abdominal pain, usually in the absence of pyrexia, nausea, vomiting or change in bowel habit, and unremarkable laboratory markers. Due to its vague presentation, epiploic appendagitis may be mistaken for other more severe causes of acute abdominal pain like diverticulitis and appendicitis, thereby causing patients to undergo unwarranted management interventions and hospital stay. Epiploic appendagitis is usually diagnosed through imaging, most commonly computed tomography (CT). This condition is largely self-resolving and can be managed conservatively with nonsteroidal anti-inflammatory drugs (NSAIDs). Operative intervention is usually employed when symptoms persist or when complications arise. We present a case of epiploic appendagitis in a patient who presented with right lower quadrant pain initially misdiagnosed as acute appendicitis.
Puerto Rico health sciences journal, 2015
Epiploic appendagitis (EA) is a rare entity caused by the inflammation of the appendix epiploica. It is a benign and self-limited condition presenting as acute onset abdominal pain. The inaccurate diagnosis of EA can lead to unnecessary hospitalization, antibiotic therapy, and surgery. Our aim is to describe the common clinical features of patients who were diagnosed with EA over a 2-year period at the San Juan Veterans Administration Hospital. A retrospective descriptive review of the records of all patients diagnosed with EA from 2007 to 2009. The clinical data was obtained through record review. Diagnoses were confirmed by 2 radiologists reviewing imaging studies. Eight patients were included in the study. All were male with a mean age of 58 years. Seven patients were overweight as per body mass index (BMI) scale. All had localized focal, non-migratory abdominal pain, most (75%) in the left lower quadrant. Nausea (37.5%), anorexia (12.5%), constipation (12.5%), and diarrhea (25%)...
An unusual cause of acute abdomen – epiploic appendagitis: report of two cases
Northern Clinics of Istanbul, 2015
Epiploic appendices, first described in 1543 by Vesalius, are fatty structures which are attached through the length of the colon and consisted of visceral peritoneum. Epiploic appendicitis is an uncommon and self-limiting disease. In this report, we aimed to present two patients with epiploic appendicitis.
Digestive Diseases and Sciences, 2004
Epiploic appendices are small lobular masses of fat emanating from the serosal surface of the colon, normally identifiable by CT only when surrounded by peritoneal fluid. However, an inflamed appendage, which can result from appendageal torsion or thrombosis of an appendageal draining vein, has a characteristic appearance on CT. With the increasing use of CT in the diagnosis of abdominal pain, primary epiploic appendagitis (PEA), a relatively uncommon and benign condition, can now be identified by pathognomonic radiological findings, thus obviating the need for hospitalization, further studies, or surgical exploration. Based upon patient series, PEA is the correct diagnosis in 2-7% of presumed diverticulitis cases and 1% of presumed appendicitis cases (1, 2). Appropriate radiological diagnosis in the otherwise non-toxic-appearing patient allows the clinician to pursue conservative management, avoiding unnecessary intervention and cost. We report three recent cases of PEA presenting to our institution, describing their clinical symptoms, laboratory and CT findings, and follow-up examinations. CASE SERIES Patient 1. A 37-year-old otherwise healthy man presented to his local emergency department with severe right lower quadrant abdominal pain. He had no associated fever, nausea, vomiting, diarrhea, or hematuria. An abdominal CT was obtained and reported to demonstrate inflammation surrounding the right colon.
Primary Epiploic Appendagitis: Solving the Puzzle of a Benign Acute Abdomen
Open Access Journal of Surgery, 2018
Background: Acute Epiploic Appendagitis is a self limiting disease due to ischemic infarction of an epiploic appendix. Diagnosis is difficult clinically due to the lack of pathognomonic clinical features, a sudden onset of sharp localized pain either in the left or right iliac fossa with minimal gastrointestinal symptoms, which can simulate a surgical clinical picture. Awareness of imaging findings of this entity is important to arrive at a correct diagnosis and to avoid unnecessary hospitalization and surgery. Methods: 25 patients diagnosed with EA were evaluated and analyzed for demographic factors clinical presentation and diagnostic radiological features. Comparison was also done with data in patients of earlier reported series.
Polish Journal of Radiology
Purpose: Acute epiploic appendagitis (EA) is a relatively rare, benign and local inflammatory disease involving the epiploic appendices. Unlike its mimics, EA is generally a self-limiting inflammatory disease and can be treated conservatively. Case presentation: A 33-year-old Caucasian man presented to our emergency department with a sever and sharp left iliac fossa pain. He underwent abdominal X-ray, ultrasound (US) and computed tomography (CT) evaluations. Conclusion: We illustrate US and CT findings to increase the radiologists' awareness of this condition and to avoid diagnostic delay and unnecessary use of antibiotics, hospitalization and surgery.
Epiploic Appendagitis Clinically Masquerading as an Acute Diverticulitis
Cureus, 2022
Acute diverticulitis is a prevalent surgical condition that typically presents with lower abdominal pain and tenderness. However, the clinical and laboratory findings of diverticulitis are non-specific and other conditions may give similar manifestations. We present the case of a middle-aged woman with a left lower quadrant abdominal pain and fever of three days duration. On examination, she had tachycardia and localized tenderness in the left iliac fossa with rebound tenderness. There were no signs of peritonitis, including the rigid abdomen and decreased bowel sounds. The laboratory findings were suggestive of an inflammatory or infectious process. A computed tomography scan of the abdomen demonstrated a fatdensity lesion anterior to the descending colon representing epiploic appendagitis. The patient was managed conservatively with non-steroidal anti-inflammatory drugs (lornoxicam 8 mg). The patient experienced gradual improvement and was discharged after four days of hospitalization. No surgical intervention was needed. The case highlighted the importance of considering epiploic appendagitis in the differential diagnosis of acute diverticulitis. An accurate diagnosis will prevent the patient from having unnecessary surgeries as conservative management is often sufficient in patients with epiploic appendagitis.