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Acute epiploic appendagitis in hernia sac: CT appearance.
Ajay K Singh1, Debra Gervais, James Rhea
1Division of Abdominal Imaging and Interventional Radiology, Wh 270, Massachusetts General hospital, 55 Fruit street, Boston, MA 02114, USA. asingh1@partners.org
Emergency Radiology
|September 1, 2005
Summary
Acute epiploic appendagitis, an uncommon cause of abdominal pain, can occur within incisional hernias. Contrast-enhanced CT scans effectively diagnosed this condition by revealing inflamed fat structures.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Pathology
Background:
- Acute epiploic appendagitis (AEA) is a rare, benign condition caused by torsion or venous occlusion of an epiploic appendage.
- Incisional hernias present a potential, though infrequent, anatomical space for intra-abdominal pathologies.
- Diagnosis of AEA typically relies on characteristic findings on contrast-enhanced computed tomography (CT).
Observation:
- A case of acute abdomen was attributed to acute epiploic appendagitis within an incisional hernia sac.
- The patient presented with symptoms suggestive of acute abdominal distress.
Findings:
- Contrast-enhanced CT revealed an oval, fat-density structure.
- Evidence of surrounding inflammation was noted in the transverse mesocolon.
- Specific CT findings indicated inflammation of the appendices epiploicae of the transverse colon, leading to a definitive diagnosis.
Implications:
- This case highlights an unusual presentation of acute epiploic appendagitis.
- Incisional hernias should be considered as a potential location for AEA in patients with acute abdomen.
- Accurate CT interpretation is crucial for diagnosing this uncommon cause of abdominal pain, potentially avoiding unnecessary surgical intervention.