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Primary epiploic appendagitis: CT diagnosis.

Kumaresan Sandrasegaran1, Dean D Maglinte, Arumugam Rajesh

  • 1Department of Radiology, Indiana University Medical Center, UH 0279, 550 N. University Blvd., Indianapolis, IN 46202-5253, USA. ksandras@iupui.edu

Emergency Radiology
|July 28, 2004
PubMed
Summary

Computed tomography (CT) signs of primary epiploic appendagitis were analyzed. CT revealed characteristic fatty lesions, aiding diagnosis and conservative management of this condition that mimics other inflammatory diseases.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Abdominal Imaging

Background:

  • Primary epiploic appendagitis is an uncommon cause of acute abdominal pain.
  • It can mimic more serious intra-abdominal inflammatory conditions, leading to misdiagnosis.
  • Accurate diagnosis is crucial for appropriate patient management and avoiding unnecessary interventions.

Purpose of the Study:

  • To analyze the computed tomography (CT) imaging features of primary epiploic appendagitis.
  • To identify characteristic CT findings that differentiate it from other causes of abdominal pain.
  • To correlate CT findings with clinical presentation and patient outcomes.

Main Methods:

  • Retrospective review of 11 cases diagnosed with primary epiploic appendagitis over 12 months.

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  • Analysis of clinical data, including presenting symptoms and preliminary diagnoses.
  • Detailed review of softcopy CT images by two experienced abdominal radiologists, assessing lesion characteristics and ancillary signs.

    • Main Results:

    • Abdominal pain was the primary symptom in all patients.
    • CT revealed solitary, ovoid fatty lesions with soft tissue stranding adjacent to the colon in all cases.
    • Ancillary signs included central hyperdensity, mild bowel wall thickening, and parietal peritoneal thickening in some patients.
    • Lesions resolved on follow-up CT in 4 patients.

    Conclusions:

    • Primary epiploic appendagitis presents with distinct CT findings, primarily a localized fatty lesion.
    • Familiarity with these CT signs aids radiologists in diagnosing epiploic appendagitis.
    • Accurate CT diagnosis facilitates a conservative management approach, avoiding unnecessary surgical interventions.