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Primary epiploic appendagitis: reconciling CT and clinical challenges
Jamel Saad1, Hussein Ali Mustafa, Asem Mohamed Elsani
1Department of Radiology, Nejran Armed Forces Hospital, Alfahd Street, Nejran, 1002, Saudi Arabia, jamalamin2003@yahoo.com.
Summary
Acute epiploic appendagitis (PEA) is often diagnosed using CT scans, which reveal characteristic findings like a central fatty core. Awareness of these findings helps avoid unnecessary surgery for this rare condition.
Area of Science:
- Abdominal Imaging
- Gastroenterology
- Surgical Pathology
Background:
- Acute epiploic appendagitis (PEA) is an uncommon cause of acute abdominal pain.
- Clinical diagnosis can be challenging due to non-specific symptoms.
Purpose of the Study:
- To elucidate the spectrum of clinical and computed tomography (CT) findings in patients diagnosed with acute epiploic appendagitis.
- To highlight the diagnostic utility of CT in PEA.
Main Methods:
- Retrospective review of clinical records and CT scans from 18 patients diagnosed with PEA.
- Data collected from two hospitals between July 2006 and June 2013.
Main Results:
- The mean age was 44.3 years, with 72% males; common symptom was left lower quadrant pain.
- CT scans showed a central fatty core with surrounding inflammation (1.5-3.5 cm) in most cases.
- Fifteen patients were managed conservatively, with most showing complete resolution within 3 months.
Conclusions:
- CT scan is crucial for accurate diagnosis of PEA, differentiating it from other causes of abdominal pain.
- Increased surgeon awareness of PEA can prevent unnecessary hospital admissions and surgical interventions.
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