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Acute epiploic appendagitis and its mimics.

Ajay K Singh1, Debra A Gervais, Peter F Hahn

  • 1Department of Radiology, University of Massachusetts Medical Center, Worcester, MA 01605, USA. pallaviajay@hotmail.com

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|November 15, 2005
PubMed
Summary

Acute epiploic appendagitis and acute omental infarction cause lower quadrant pain and mimic other conditions. Accurate computed tomography (CT) diagnosis is crucial to prevent unnecessary surgery for these fatty abdominal conditions.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Abdominal Imaging

Background:

  • Acute lower quadrant pain is a common presentation.
  • Clinical features of acute epiploic appendagitis resemble acute diverticulitis or appendicitis.
  • Mimics include acute omental infarction, mesenteric panniculitis, and inflammatory bowel conditions.

Purpose of the Study:

  • To differentiate acute epiploic appendagitis from its mimics on computed tomography (CT).
  • To highlight the importance of accurate CT diagnosis for appropriate patient management.
  • To prevent unnecessary surgical interventions for these conditions.

Main Methods:

  • Review of computed tomography (CT) findings in patients with acute abdominal pain.
  • Analysis of characteristic CT features differentiating acute epiploic appendagitis from acute omental infarction.

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  • Comparison of imaging findings with clinical presentations.

    • Main Results:

    • Acute epiploic appendagitis presents as an oval, fat-attenuating lesion adjacent to the sigmoid colon.
    • Acute omental infarction appears as a heterogeneous fatty mass with specific fat stranding patterns.
    • Location and specific CT features aid in distinguishing these entities.

    Conclusions:

    • Accurate CT interpretation is essential for diagnosing acute epiploic appendagitis and acute omental infarction.
    • Distinguishing these conditions from surgical emergencies like appendicitis and diverticulitis is critical.
    • Correct diagnosis on CT can prevent unnecessary surgery and guide appropriate management.