Epiploic appendagitis

Case contributed by Jeremy Jones
Diagnosis almost certain

Presentation

Left lower abdominal pain.

Patient Data

Age: Adult (middle age)
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

CT abdomen

ct

CT scan with poor contrast opacification demonstrates a fat-density ovoid mass with surrounding inflammatory stranding in the left iliac fossa. It abuts the sigmoid colon. No free fluid or free gas visible. 

Annotated images

Annotated image

An epiploic appendage is seen as a rounded fat density structure (yellow dotted line) with extensive surrounding stranding. Centrally a dot is present (green arrow) representing the thrombosed vascular pedicle. 

Case Discussion

This case demonstrates the classical appearance of epiploic appendagitis. It is an important diagnosis to make as it avoids unnecessary surgery. The diagnosis can be made with confidence when imaging appearances are characteristic. 

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