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CT features of primary epiploic appendagitis.
Keng Sin Ng1, Andrew Gee Seng Tan, Kevin K'o Wen Chen
1Department of Oncologic Imaging, National Cancer Centre, 11 Hospital Drive, Singapore 169610, Singapore. ngkeng@gmail.com
European Journal of Radiology
|April 4, 2006
Summary
Computed tomography (CT) findings for primary epiploic appendagitis (PEA) include a hyperattenuated ring with fat stranding. Recognizing these CT signs aids in diagnosis and avoids unnecessary surgery for acute abdominal pain.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Pathology
Background:
- Primary epiploic appendagitis (PEA) is a rare, benign condition causing acute abdominal pain.
- It results from torsion or venous occlusion of an epiploic appendage.
Purpose of the Study:
- To describe the computed tomography (CT) findings characteristic of primary epiploic appendagitis (PEA).
Main Methods:
- Retrospective review of clinical records and CT images from 14 patients with suspected PEA.
- Analysis of radiological signs, including hyperattenuated ring, fat stranding, central dot, and fatty mass appearance.
Main Results:
- All patients exhibited a hyperattenuated ring with adjacent fat stranding on CT.
- A central high attenuation dot was observed in 42.9% of cases.
- A lobulated fatty mass, suggestive of contiguous infarcted appendages, was seen in 21.4% of patients.
Conclusions:
- The CT findings, particularly the hyperattenuated ring and fat stranding, are indicative of PEA.
- A lobulated fatty mass appearance can represent multiple infarcted epiploic appendages.
- Accurate CT interpretation of PEA can lead to confident diagnosis and prevent unnecessary surgical intervention.