Atypical acute epiploic appendagitis

Case contributed by Craig Hacking
Diagnosis almost certain

Presentation

Several days of LLQ pain. Moderate tenderness but no rebound.

Patient Data

Age: 30 years
Gender: Male

Fat stranding surrounds a short segment of the sigmoid colon in the LLQ. There is a small focus of fat density in the center of the inflamed pericolic tissues, posterolateral to the sigmoid colon (axial image 88).

No free fluid or free gas.

Case Discussion

Findings are in keeping with acute epiploic appendagitis. The patient self discharged.

Usually, the inflamed epipolic appendage is located on the anterior surface of the sigmoid or descending colon.

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