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Related Experiment Videos

Epiploic appendagitis: the emergency department presentation.

Eric L Legome1, Austin L Belton, Robert E Murray

  • 1Department of Emergency Medicine, Massachusetts General Hospital and Division of Emergency Medicine, Harvard Medical School, Boston, Massachusetts 02114, USA.

The Journal of Emergency Medicine
|January 26, 2002
PubMed
Summary

Epiploic appendagitis (EA), an inflammation of adipose tissue along the colon, often presents with localized abdominal pain. This study identified key clinical features in emergency department patients diagnosed with EA, highlighting its conservative management.

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Area of Science:

  • Gastroenterology
  • Radiology
  • Emergency Medicine

Background:

  • Epiploic appendagitis (EA) is an uncommon cause of acute abdominal pain.
  • It involves inflammation of the appendix epiploica, a small fatty appendage of the colon.
  • EA can mimic surgical abdominal conditions, necessitating accurate diagnosis.

Purpose of the Study:

  • To describe the clinical characteristics of patients diagnosed with epiploic appendagitis in the emergency department.
  • To identify features that aid in the diagnosis of EA using computed tomography (CT) scans.
  • To inform clinicians about EA as an increasing diagnosis in emergency settings.

Main Methods:

  • Structured retrospective chart review of emergency department patients.
  • Diagnosis confirmed by history, physical examination, and abdominal computed tomography (CT) scan.

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  • Follow-up data collected for 85% of diagnosed patients.

    • Main Results:

    • Nineteen patients were diagnosed with epiploic appendagitis.
    • All patients presented with focal, nonmigratory abdominal pain.
    • Common findings included left lower quadrant pain, guarding, normal temperature, and normal white blood cell count.
    • No patients required surgical intervention.

    Conclusions:

    • Epiploic appendagitis is characterized by focal abdominal pain and typically presents with normal inflammatory markers.
    • Increased utilization of CT scans for abdominal pain will lead to more frequent encounters with EA.
    • Recognizing these clinical features can help clinicians consider CT for diagnosis and avoid unnecessary surgery.