SONOWORLD : Acute epiploic appendagitis

Username

Password

186,684 Registered Members as of 04/22/2021.

JavaScript must be enabled in order for you to use Sonoworld.com in standard view. However, it seems JavaScript is either disabled or not supported by your browser. To use standard view, enable JavaScript by changing your browser options, then try again.

Abdomen » Mesentry And Omentum

Acute epiploic appendagitis

« Back to Listing

Author(s) :

Danilo Sirigu, MD

Presentation 71-year-old woman patient with left lower quadrant pain. The abdominal examination was normal except for obesity and significant tenderness upon superficial palpation in the left lower quadrant of the abdomen.

Caption: Real time ultrasound left lower quadrant

Description: Sonography at the site of severe abdominal pain demonstrated an ovoid, hyperechoic, non compressible mass adjacent to the colonic wall. Color Doppler showed no flow in the lesion.

Caption: CT Scan

Description: CT scan shows fat-density lesion with surrounding hyperdense rim and inflammation abutting the sigmoid colon and anterior abdominal wall musculature.

Differential Diagnosis acute diverticulitis
appendicitis
acute epiploic appendagitis

Final Diagnosis acute epiploic appendagitis

Discussion Acute epiploic appendagitis is an uncommon cause of abdominal pain, that occurs secondary to torsion or spontaneous venous thrombosis of a draining vein from the serosal surface of the colon.

Clinically, it is most often mistaken for acute diverticulitis.

Acute epiploic appendagitis is associated with obesity and hernia .

Rarely, acute epiploic appendagitis may result in adhesion, bowel obstruction, intussusception, intraperitoneal loose body, peritonitis .

Epiploic appendagitis is a self-limiting disease that has been reported in approximately 1% of patients clinically suspected of having appendicitis .

Case References

Lee YC, Wang HP, Huang SP, Chen YF, Wu MS, Lin JT. Gray-scale and color Doppler sonographic diagnosis of epiploic appendagitis. J Clin Ultrasound 2001;29:197 -199
Sirvanci M, Tekelioglu MH, Duran C, Yardimci H, Onat L, Ozer K. Primary epiploic appendagitis: CT manifestations. Clin Imaging 2000;24:357 -361
Van Breda Vriesman AC, Puylaert JB. Epiploic appendagitis and omental infarction: pitfalls and look-alikes. Abdom Imaging 2002; 27:20 -28
Acute epiploic appendagitis and its mimics. Singh AK, Gervais DA, Hahn PF, Sagar P, Mueller PR, Novelline RA. 1: Radiographics. 2005 Nov-Dec;25(6):1521-34. http://www.ncbi.nlm.nih.gov/pubmed/16284132?dopt=Abstract

Technical Details This case was provided courtesy of Dr. Danilo Sirigu and the EchoMovies web site at www.ecomovies.it