[Differential diagnosis of a hemorrhagic-necrotizing epiploic appendix]

In a 52 year old pyknic patient in whom very violent pain had suddenly occurred in the left lower abdomen, an acute hemorrhagic infarction of an epiploic appendix of the sigmoid colon with adhesion to the anterior abdominal wall was found to be the cause of the symptoms. A hernia, above all a hernia of the semilunar line of Spigelius, an inflammatory process and a granuloma had to be considered in the differential diagnosis.