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Primary epiploic appendagitis: evolutionary changes in CT appearance

P M Rao1, J Wittenberg, J N Lawrason

  • 1Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.

Radiology
|September 1, 1997
PubMed
Summary
This summary is machine-generated.

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Computed tomographic (CT) imaging reveals characteristic changes in primary epiploic appendagitis over time. Awareness of these CT findings aids in differentiating pericolonic abnormalities.

Area of Science:

  • Radiology
  • Gastroenterology
  • Abdominal Imaging

Background:

  • Primary epiploic appendagitis is a rare, benign condition causing focal, self-limiting inflammation.
  • It often mimics more serious intra-abdominal pathologies like diverticulitis or appendicitis.
  • Accurate diagnosis relies heavily on characteristic imaging findings.

Purpose of the Study:

  • To document and analyze the evolving computed tomographic (CT) features of primary epiploic appendagitis.
  • To identify key imaging markers for acute and healing stages of the condition.

Main Methods:

  • Retrospective review of clinical records and CT scans from 10 patients diagnosed with primary epiploic appendagitis.
  • Analysis of initial CT scans at presentation and follow-up scans (1-84 weeks later).

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Main Results:

  • Initial CT showed oval/round lesions (mean 14x21 mm) with fat stranding and peritoneal thickening.
  • Follow-up CT demonstrated residual abnormalities (mean 10x15 mm) with decreased fat stranding and altered attenuation.
  • Remnant lesions varied, including fatty attenuation, soft-tissue nodules, or residual fat stranding.

Conclusions:

  • Computed tomographic (CT) imaging demonstrates distinct changes in primary epiploic appendagitis during acute and healing phases.
  • Recognizing these evolving CT appearances is crucial for accurate differential diagnosis of pericolonic abnormalities.
  • This understanding can potentially reduce unnecessary surgical interventions.