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Acute epiploic appendagitis: CT findings in 33 cases
Rivka Zissin1, Marjorie Hertz, Alexandra Osadchy
1Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, 44281, Israel. Zisin.Rivka@clalit.org.il
Emergency Radiology
|August 4, 2004
Summary
Acute epiploic appendagitis (AEA) is a benign condition causing abdominal pain. Characteristic CT scan findings can accurately diagnose AEA, differentiating it from other common abdominal conditions.
Area of Science:
- Radiology
- Gastroenterology
- Abdominal Imaging
Background:
- Acute epiploic appendagitis (AEA) is a common cause of acute abdominal pain.
- AEA is often misdiagnosed as diverticulitis or appendicitis due to similar clinical presentations.
- Computed tomography (CT) offers a pathognomonic appearance for AEA.
Purpose of the Study:
- To review the CT findings in patients diagnosed with AEA.
- To determine the diagnostic accuracy of CT for AEA.
- To highlight AEA's role in the differential diagnosis of acute abdominal pain.
Main Methods:
- Retrospective review of CT scans from 33 adult patients diagnosed with AEA over 33 months.
- Analysis of patient demographics, clinical presentation, and CT findings.
- Comparison of CT findings with clinical diagnoses.
Main Results:
- All 33 patients exhibited characteristic CT findings of AEA, including an oval fatty mass with central densities and mesenteric stranding.
- Abdominal pain was predominantly in the left lower quadrant (21 patients) or right lower quadrant (9 patients).
- Associated findings included adjacent colonic mural thickening (16 patients) and peritoneal fluid (7 patients).
Conclusions:
- CT imaging is a reliable modality for diagnosing AEA.
- AEA should be considered in the differential diagnosis of acute abdominal pain, especially in young males with left lower quadrant pain.
- Accurate CT diagnosis can prevent unnecessary surgery.