Epiploic appendagitis is an uncommon, benign inflammatory process of epiploic appendages which are adipose structures protruding from the colon. Epiploic appendagitis is an infrequent, often misdiagnosed cause of abdominal pain. Its diagnosis can be suspected in adult patients with well-localised acute abdominal pain with no or only mild systemic inflammation. Fever is usually absent or mild, and leukocytes and C reactive protein are usually normal or slightly elevated. The diagnosis can be made with ultrasonography which shows a hyperechoic, ovoid, non-compressible, solid mass at the site of maximum abdominal tenderness, often surrounded by a hypoechoic rim. Sonologists should be aware of this self-limiting and benign disease, which mimics other abdominal acute conditions, such as diverticulitis, cholecystitis and appendicitis, so that unnecessary intervention can be avoided.
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