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CT appearance of acute appendagitis.
Ajay K Singh1, Debra A Gervais, Peter F Hahn
1Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
AJR. American Journal of Roentgenology
|October 27, 2004
Summary
Acute epiploic appendagitis typically appears on CT as a fat-density oval lesion with surrounding inflammation, most commonly on the anterior sigmoid colon. Follow-up CT findings can vary, showing resolution or persistent changes.
Area of Science:
- Radiology
- Gastroenterology
- Abdominal Imaging
Background:
- Acute epiploic appendagitis is a benign condition causing focal abdominal pain.
- Accurate CT diagnosis is crucial to avoid unnecessary interventions.
Purpose of the Study:
- To characterize the spectrum of CT findings in acute epiploic appendagitis.
- To evaluate the evolution of CT findings over time.
Main Methods:
- Retrospective analysis of contrast-enhanced CT scans from 50 patients with acute epiploic appendagitis.
- Evaluation of CT features including location, size, fat density, and associated inflammation.
- Comparison of initial CT findings with follow-up scans in 10 patients.
Main Results:
- The sigmoid colon was the most common location (31/50), typically anterior to the colon (41/50).
- All cases showed a central fatty core with surrounding inflammation; colon wall thickening was rare (2/50).
- Follow-up CT demonstrated variable changes, including resolution, decreased size, or persistent findings.
Conclusions:
- CT findings of acute epiploic appendagitis are predictable in terms of location, size, and density.
- A fat-density oval lesion with inflammation anterior to the sigmoid colon is characteristic.
- CT changes over 2 weeks to 6 months are not consistently predictable.