Epiploic appendagitis of the vermiform appendix: Diagnostic challenge and radiologic differentiation

Epiploic appendagitis is a self-limiting inflammatory condition caused by ischemic infarction of an epiploic appendage due to torsion or spontaneous venous thrombosis. Its clinical presentation often mimics acute abdominal conditions such as appendicitis or diverticulitis, making diagnosis challenging. However, epiploic appendagitis involving the vermiform appendix is an infrequent entity. Diagnosis primarily relies on computed tomography, as clinical and laboratory findings are nonspecific. Recognizing this condition is crucial to preventing unnecessary hospitalizations, antibiotic therapy, and surgical interventions. We present the case of a 28-year-old male with a history of testicular cancer who presented with a 3-day history of right iliac fossa pain. Contrast-enhanced abdominopelvic computed tomography suggested the diagnosis of epiploic appendagitis of the vermiform appendix. This case highlights the importance of considering epiploic appendagitis involving the vermiform appendix in the differential diagnosis of acute abdominal pain, particularly in distinguishing it from acute appendicitis.