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[Radiologic aspects of infarction of the appendix epiploica]
C Barbier1, P Denny, J M Pradoura
1Service d'Imagerie Médicale, Centre Hospitalier Jean-Monnet, Epinal.
Abstract:
Clinical, US, CT and MR findings were reviewed in 5 patients with primary epiploic appendagitis (3 men, 2 women, mean age 38 years, age range 29-62 years) seen between December 1994 and December 1997. Diagnosis was reached in all cases with CT, with US in 3 and with MR in 1. Follow-up CT was performed in 2 cases and clinical follow-up in 4. One patient underwent surgery. Initial US, CT or MR examinations revealed a fatty oval-shaped nodule located anteriorly or anterolaterally to the left colon. The greater diameter ranged from 20 to 30 mm. Perinodular lesions with strands of periappendicular fat and thickened parietal peritoneum were visualized in all cases without any other inflammatory process in the abdomen. Symptoms resolved within 4 days in all patients. Signs of fatty inflammatory processes resolved in the 2 patients who had follow-up CTs. Primary epiploic appendagitis has characteristic US, CT and MR features which help guide medical treatment.
Insights
Primary epiploic appendagitis, an inflammation of the omentum, presents distinct imaging features on ultrasound (US), CT, and MR. These characteristic findings aid in accurate diagnosis and guide non-surgical management.
Area of Science:
- Radiology
- Gastroenterology
- Abdominal Imaging
Background:
- Epiploic appendagitis is a rare, focal, and benign condition.
- It involves inflammation of the epiploic appendages, small fatty pouches attached to the colon.
Purpose of the Study:
- To describe the clinical, US, CT, and MR findings in patients with primary epiploic appendagitis.
- To evaluate the diagnostic accuracy of different imaging modalities.
Main Methods:
- Retrospective review of clinical data and imaging findings (US, CT, MR) in 5 patients.
- Follow-up imaging (CT) and clinical assessment were performed.
Main Results:
- CT diagnosed all 5 cases; US diagnosed 3 cases; MR diagnosed 1 case.
- Imaging revealed a characteristic fatty oval-shaped nodule (20-30 mm) with surrounding inflammatory changes.
- Symptoms resolved within 4 days; imaging signs of inflammation resolved in follow-up studies.
Conclusions:
- Primary epiploic appendagitis has distinctive imaging features on US, CT, and MR.
- These characteristic findings facilitate accurate diagnosis and support medical management, often avoiding surgery.