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Multidetector computed tomography diagnosis of primary and secondary epiploic appendagitis

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Abstract

Purpose

The aim of this study was to evaluate the epiploic appendages in patients with acute abdomen using multidetector computed tomography (MDCT) and to determine the incidence of primary and secondary epiploic appendagitis (EA).

Materials and methods

A radiologist reviewed MDCT images from 1338 patients with acute abdomen for visible epiploic appendages. Two radiologists then reviewed the MDCT images showing inflamed epiploic appendages and diagnosed primary EA, secondary EA, or other conditions by consensus. The CT criteria for primary EA are a round or oval pericolonic fatty lesion with a hyperattenuated rim and adjacent fat stranding, without other causes of inflammation. Secondary EA is diagnosed if an epiploic appendage is found to be due to inflammation from other inflammatory entities.

Results

Epiploic appendages were identified in 19 patients. Four patients (0.3%) had a retrospective CT diagnosis of primary EA. Twelve patients (0.9%) had a retrospective CT diagnosis of secondary EA (primary condition was diverticulitis in 10 patients and inflammatory bowel disease in 2 patients). The remaining three patients had calcification of an epiploic appendage suggestive of old EA.

Conclusion

Primary EA should be included in the differential diagnosis of acute abdomen. Occasionally, inflammation of the epiploic appendages is secondary to other inflammatory conditions.

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References

  1. Singh AK, Gervais DA, Hahn PF, Sagar P, Mueller PR, Novelline RA. Acute epiploic appendagitis and its mimics. Radiographics 2005;25:1521–1534.

    Article  PubMed  Google Scholar 

  2. Rioux M, Langis P. Primary epiploic appendagitis: clinical, US, and CT findings in 14 cases. Radiology 1994;191:523–526.

    PubMed  CAS  Google Scholar 

  3. Sirvanci M, Tekelioglu MH, Duran C, Yardimci H, Onat L, Ozer K. Primary epiploic appendagitis: CT manifestations. Clin Imaging 2000;24:357–361.

    Article  PubMed  CAS  Google Scholar 

  4. Sandrasegaran K, Maglinte DD, Rajesh A, Akisik FM. Primary epiploic appendagitis: CT diagnosis. Emerg Radiol 2004;11:9–14.

    Article  PubMed  Google Scholar 

  5. Zissin R, Hertz M, Osadchy A, Kots E, Shapiro-Feinberg M, Paran H. Acute epiploic appendagitis: CT findings in 33 cases. Emerg Radiol 2002;9:262–265.

    PubMed  Google Scholar 

  6. Singh AK, Gervais DA, Hahn PF, Rhea J, Mueller PR. CT appearance of acute appendagitis. AJR Am J Roentgenol 2004;183:1303–1307.

    PubMed  Google Scholar 

  7. Ng KS, Tan AG, Chen KK, Wong SK, Tan HM. CT features of primary epiploic appendagitis. Eur J Radiol 2006;59:284–288.

    Article  PubMed  Google Scholar 

  8. Lynn TE, Docherty MB, Waugh JM. A clinical pathologic study of the epiploic appendages. Surg Gyneoecia Obstet 1956;103:423–433.

    Google Scholar 

  9. Talukdar R, Saikia N, Mazumder S, Gupta C, Khanna S, Chaudhuri D, et al. Epiploic appendagitis: report of two cases. Surg Today 2007;37:150–153.

    Article  PubMed  Google Scholar 

  10. Blinder E, Ledbetter S, Rybicki F. Primary epiploic appendagitis. Emerg Radiol 2002;9:231–233.

    PubMed  Google Scholar 

  11. Danielson K, Chernin MM, Amberg JR, Goff S, Durham JR. Epiploic appendicitis: CT characteristics. J Comput Assist Tomogr 1986;10:142–143.

    Article  PubMed  CAS  Google Scholar 

  12. Rao PM, Rhea JT, Wittenberg J, Warshaw AL. Misdiagnosis of primary epiploic appendagitis. Am J Surg 1998;176:81–85.

    Article  PubMed  CAS  Google Scholar 

  13. Singh AK, Gervais DA, Lee P, Westra S, Hahn PF, Novelline RA et al. Omental infarct: CT imaging features. Abdom Imaging 2006;31:549–554.

    Article  PubMed  CAS  Google Scholar 

  14. Hollerweger A, Macheiner P, Rettenbacher T, Gritzmann N. Primary epiploic appendagitis: sonographic findings with CT correlation. J Clin Ultrasound 2002;30:481–495.

    Article  PubMed  Google Scholar 

  15. Pickhardt PJ, Bhalla S. Unusual nonneoplastic peritoneal and subperitoneal conditions: CT findings. Radiographics 2005;25:719–730.

    Article  PubMed  Google Scholar 

  16. Karhunen PJ. Hepatic pseudolipoma. J Clin Pathol 1985;38:877–879.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Hisato Osada.

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Osada, H., Ohno, H., Watanabe, W. et al. Multidetector computed tomography diagnosis of primary and secondary epiploic appendagitis. Radiat Med 26, 582–586 (2008). https://doi.org/10.1007/s11604-008-0278-z

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  • DOI: https://doi.org/10.1007/s11604-008-0278-z

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