Epiploic appendagitis

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain

Presentation

Right sided abdominal pain.

Patient Data

Age: 50 years
ultrasound

An ovoid soft tissue mass feature is seen just beneath and adherent to the right side of the anterior abdominal wall, in close relation to the ascending colon. It shows internal heterogenous hypoechogenicity. It measures 3 x 4.5 cm in its two maximum dimensions. The gallbladder is contracted and full of calculi.

ct

An ovoid soft tissue mass lesion is seen adherent to the right side of the interior of the anterior abdominal wall in close relation to the ascending colon. It shows internal heterogenous hypodensities and surrounded by a hyperdense rim. It measures 3 x 5.3 cm in its two maximum dimensions. It shows no significant enhancement in the post-contrast study. Reactive surrounding peritoneal strands are seen. Cholelithiasis is noted.

Photo

Post surgical excision of the lesion that proved to be epiploic appendagitis.

Case Discussion

The usual management of epiploic appendagitis is conservative but in this case the surgeon operated with a view to a cholecystectomy and explored for the possible other diagnoses such as omental neoplasm.

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