An unusual cause of hematuria; primary epiploic appendagitis

Primary epiploic appendagitis (PEA) is self limiting inflammatory disease of colonic epiploic appendices.

Herein, a 40 years old patient describing abdomino-inguinal pain with clotty hematuria having PEA was presented. At first, the patient was thought to have a primary bladder pathology, but after a meticioulus examination, he found to have PEA and managed by conservative measures.

Although PEA does not require surgical intervention, it may mimic other acute abdominal disorders which can be difficult to differentiate. Appendices overlying the sigmoid colon and cecum are more prone to be affected as they are more elongated and wider in size. The patient is usually admitted due to sudden onset of abdominal pain accompanied with fever, abdominal tenderness and leucocytosis.

The present case demonstrated that PEA located close to the lower urinary tract especially urinary bladder might present with urinary symptoms such as hematuria. dysuria, pollakuria and inguinal pain.