Epiploic appendagitis

Case contributed by Gustavo Aguiar
Diagnosis almost certain


Right upper quadrant abdominal pain

Patient Data

Age: 40 years
Gender: Male

A rounded lesion with a high signal intensity on T1 and T2WI, situated on the antimesenteric border of the hepatic flexure. The lesion shows rim enhancement on T1 C+ (Gd).

Multiple calculi in the gallbladder are also identified.

Case Discussion

In this case, the initial clinical suspicion was acute cholecystitis. There are multiple calculi in the gallbladder, however, there is no wall thickening or pericholecystic fluid. The lesion identified on the antimesenteric border of the hepatic flexure suggests an inflammatory process involving an epiploic appendage of the colon - epiploic appendagitis. The diagnosis is most frequently made on CT, as the disease may simulate any acute abdominal condition.

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