Epiploic appendagitis

Case contributed by Dr David Puebla

Presentation

Left sided abdominal pain with rebound and guarding.

Patient Data

Age: 36 years
Gender: Male
CT

Oval fat density lesion, a ring area of high attenuation and surrounding fat stranding, adjacent to the distal descending colon. 

Annotated image

See below.

Case Discussion

Epiploic appendages are peritoneal outpouchings that arise from the serosal surface of the colon, contain adipose tissue and vessels, and can be up to 5 cm in length. The inflammation of epiploic appendages can be the result of torsion or venous occlusion 

The differential diagnosis of an inflammatory fatty lesion on CT includes acute epiploic appendagitis, mesenteric panniculitis, acute diverticulitis, trauma, or an omental neoplasm such as a liposarcoma 

Epiploic appendagitis does not require surgical or medical intervention. It is self-limiting. Pain can be treated with analgesics and subsides in about a week. 

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Case information

rID: 18459
Case created: 8th Jul 2012
Last edited: 29th Nov 2015
Inclusion in quiz mode: Included

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