Advertisement

Epiploic Appendagitis

  • Giovanni Maconi
  • Federica Furfaro
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

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.

Keywords

Acute Diverticulitis Parietal Peritoneum Epiploic Appendagitis Free Intraperitoneal Fluid Abdominal Acute Condition 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Carmichael DH, Organ CH Jr (1985) Epiploic disorders. Conditions of the epiploic appendages. Arch Surg 120:1167–1172PubMedCrossRefGoogle Scholar
  2. Chen JH, Wu CC, Wu PH (2011) Epiploic appendagitis: an uncommon and easily misdiagnosed disease. J Dig Dis 12:448–452Google Scholar
  3. Choi YU, Choi PW, Park YH et al (2011) Clinical characteristics of primary epiploic appendagitis. J Korean Soc Coloproctol 27:114–121Google Scholar
  4. Ghahremani GG, White EM, Hoff FL et al (1992) Appendices epiploicae of the colon: radiologic and pathologic features. Radiographics 12:59–77PubMedGoogle Scholar
  5. Görg C, Egbring J, Bert T (2009) Contrast-enhanced ultrasound of epiploic appendagitis. Ultrashall Med 30:163–167CrossRefGoogle Scholar
  6. Hasbahceci M, Erol C, Seker M (2012) Epiploic appendagitis: is there need for surgery to confirm diagnosis in spite of clinical and radiological findings? World J Surg 36:441–446PubMedCrossRefGoogle Scholar
  7. Hollerweger A, Macheiner P, Rettenbacher T, Gritzmann N (2002) Primary epiploic appendagitis: sonographic findings with CT correlation. J Clin Ultrasound 30:481–495PubMedCrossRefGoogle Scholar
  8. Horton KM, Corl FM, Fishman EK (2000) CT evaluation of the colon: inflammatory disease. Radiographics 20:399–418PubMedGoogle Scholar
  9. Jennings CM, Collins MC (1987) The radiological findings in torsion of an appendix epiploica. Br J Radiol 60:508–509PubMedCrossRefGoogle Scholar
  10. Kim YS, Kim Y, Cho OK et al (2001) Sonography for right lower quadrant pain. J Clin Ultrasound 29:157–185PubMedCrossRefGoogle Scholar
  11. Legome EL, Belton AL, Murray RE et al (2002) Epiploic appendagitis: the emergency department presentation. J Emerg Med 22:9–13PubMedCrossRefGoogle Scholar
  12. Molla E, Rippoles T, Martinez MJ et al (1998) Primary epiploic appendagitis: US and CT findings. Eur Radiol 8:435–438PubMedCrossRefGoogle Scholar
  13. Ozdemir S, Gulpinar K, Leventoglu S et al (2010) Torsion of the primary epiploic appendagitis: a case series and review of the literature. Am J Surg 199:453–458PubMedCrossRefGoogle Scholar
  14. Rao PM, Wittenberg J, Lawrason JN (1997) Primary epiploic appendagitis: evolutionary changes in CT appearance. Radiology 204:713–717PubMedGoogle Scholar
  15. Rioux M, Langis P (1994) Primary epiploic appendagitis: clinical, US, and CT findings in 14 cases. Radiology 191:523–526PubMedGoogle Scholar
  16. Sand M, Gelos M, Bechara FG et al (2007) Epiploic appendagitis–clinical characteristics of an uncommon surgical diagnosis. BMC Surg 7:11PubMedCrossRefGoogle Scholar
  17. Schnedl WJ, Krause R, Tafeit E et al (2011) Insights into epiploic appendagitis. Nat Rev Gastroenterol Hepatol 8:45–49PubMedCrossRefGoogle Scholar
  18. Singh AK, Gervais DA, Hahn PF, Sagar P, Mueller PR, Novelline RA (2005) Acute epiploic appendagitis and its mimics. Radiographics 25:1521–1534PubMedCrossRefGoogle Scholar
  19. van Breda Vriesman AC, Lohle PNM, Coercamp EG et al (1999) Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history. Eur Radiol 9:1886PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Gastroenterology UnitDepartment of Biomedical and Clinical Sciences, “L. Sacco” University HospitalMilanItaly

Personalised recommendations