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Primary epiploic appendagitis: clinical and radiological manifestations
N Hiller1, D Berelowitz, I Hadas-Halpern
1Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel. hiller@netvision.net.il
The Israel Medical Association Journal : IMAJ
|May 10, 2001
Summary
Primary epiploic appendagitis, a rare cause of abdominal pain, can be accurately diagnosed using computed tomography (CT) scans. Early CT diagnosis helps avoid unnecessary surgery for this non-surgical condition.
Area of Science:
- Gastroenterology
- Radiology
- Abdominal Imaging
Background:
- Primary epiploic appendagitis is a rare condition causing localized abdominal pain due to epiploic appendix torsion and inflammation.
- It often mimics surgical emergencies like appendicitis or diverticulitis, leading to potential misdiagnosis.
Purpose of the Study:
- To investigate the clinical, laboratory, and radiological findings of primary epiploic appendagitis.
- To highlight computed tomography (CT) as the gold standard for diagnosis.
Main Methods:
- A retrospective review of five patients diagnosed with primary epiploic appendagitis between 1995 and 1998.
- Clinical, laboratory, and imaging data were analyzed and compared with existing literature.
- Emphasis was placed on CT findings.
Main Results:
- All patients presented with left lower quadrant abdominal pain.
- CT revealed a characteristic pericolic fatty mass with increased attenuation, a high-attenuation rim, and focal fat stranding.
- Absence of adjacent bowel wall thickening was a key diagnostic clue.
Conclusions:
- Primary epiploic appendagitis is a rare condition that can be misdiagnosed, potentially leading to unnecessary surgery.
- Accurate interpretation of CT findings allows for early diagnosis and appropriate conservative management.