Epiploic Appendagitis: A Rare Cause of Acute Abdominal Pain

Key words: epiploic appendagitis, computed tomography, acute abdomen

A previously healthy 48-year-old man presented with sudden-onset lower left abdominal pain, which persisted for 3 days. On physical examination, he had left lower quadrant tenderness. Laboratory results showed an increased white blood cell count (9.8 × 1000/μl) and increased C-reactive protein (1.8 mg/dL). Abdominal computed tomography (CT) revealed a fat-density ovoid structure with a high-density rim adjacent to the sigmoid colon and surrounding inflammatory fat, which was consistent with epiploic appendagitis (Figure 1). The patient was treated with a nonsteroidal anti-inflammatory drug and his pain resolved after 1 week. Epiploic appendagitis has nonspecific clinical findings ⁽¹⁾, and abdominal CT is of critical importance to properly diagnose this disease and distinguish it from other surgical emergencies responsible for acute abdomen ⁽²⁾. This condition is basically a self-limiting disease; however, laparoscopic appendage excision may be required for recurrent cases ⁽¹⁾. Epiploic appendagitis is a rare condition but should be considered in patients with acute abdominal pain.

Figure 1. Computed tomography revealed the presence of a fat-density ovoid structure with a high-density rim adjacent to the sigmoid colon and surrounding inflammatory fat, suggesting epiploic appendagitis.

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Author Contributions

MI wrote the first draft and managed the submission processes. All authors (1) made substantial contributions to the study concept and data analysis/interpretation; (2) drafted the manuscript and revised it critically for important intellectual content; (3) approved the final version of the manuscript to be published; and (4) agreed to be accountable for all aspects of the work.

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References

1. 1.

   Giannis D, Matenoglou E, Sidiropoulou MS, et al. Epiploic appendagitis: pathogenesis, clinical findings and imaging clues of a misdiagnosed mimicker. Ann Transl Med. 2019;7(24):814-22.

   • View Article
   • PubMed

2. 2.

   Giambelluca D, Cannella R, Caruana G, et al. CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. Insights Imaging. 2019;10(1):26-35.

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   • PubMed