Epiploic appendage

Dr Yair Glick ◉ and Dr Henry Knipe ◉ ◈ et al.

Epiploic appendages (or appendix epiploica, plural: appendices epiploicae) are peritoneum-lined protrusions of subserosal fat that arise from the surface of the large bowel.

Epiploic appendages typically measure 1.5 x 3.5 cm but have been reported to measure up to 15 cm in length ⁴. There are between 50-100 of them in the large bowel, from the cecum (where they may be absent) to the rectosigmoid junction. They are distributed longitudinally in two rows on the medial (along the taenia libera) and the posterolateral (along the taenia omentalis) aspects of the large bowel. There is only one row of epiploic appendages along the transverse colon and there are none along the rectum.

Blood supply

They are supplied by one to two small nutrient arteries that pierce the bowel serosa; it is here where colonic diverticula are thought to arise.

Radiographic features

Not normally visible on fluoroscopy, radiography or CT, unless they are surrounded by contrasting material (e.g. hemoperitoneum, ascites, or contrast medium from hysterosalpingography) ⁴.