Epiploic Appendagitis Causing Small Bowel Obstruction: A Pleasant Surprise.

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Epiploic appendagitis is an uncommon cause of acute abdominal pain.
• It often mimics more common conditions like diverticulitis or appendicitis.
• Small bowel obstruction secondary to epiploic appendagitis is exceptionally rare.

Observation:

• A 69-year-old male presented with acute abdominal pain and vomiting.
• Clinical, laboratory, and imaging findings indicated small bowel obstruction.
• Conservative management failed, leading to surgical exploration.

Findings:

• Surgical findings revealed a dilated terminal ileum adhered to the sigmoid colon.
• An inflamed epiploic appendix was identified as the cause of adhesion and obstruction.
• Resection of the inflamed epiploic appendix resolved the obstruction.

Implications:

• Epiploic appendagitis, though rare, should be considered in the differential diagnosis of small bowel obstruction.
• This case underscores the importance of surgical evaluation when conservative measures fail.
• Prompt diagnosis and management of epiploic appendagitis can prevent complications.