Right upper quadrant abdominal pain
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A rounded lesion with a high sinal 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.
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.
- Sirvanci M, Balci NC, Karaman K, Duran C, Karakaş E. Primary epiploic appendagitis: MRI findings. (2002) Magnetic resonance imaging. 20 (1): 137-9. Pubmed
- Almeida AT, Melão L, Viamonte B, Cunha R, Pereira JM. Epiploic appendagitis: an entity frequently unknown to clinicians--diagnostic imaging, pitfalls, and look-alikes. (2009) AJR. American journal of roentgenology. 193 (5): 1243-51. doi:10.2214/AJR.08.2071 - Pubmed