Presentation
Four days history of abdominal pain in the left lower quadrant with guarding.
Patient Data
Age: 40 years
Gender: Male
From the case:
Epiploic appendagitis
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Ultrasound of the left lower quadrant showing an ovoid non-compressible hyperechoic mass (5.5x5x2.7 cm) with surrounding hypoechoic rim, located anterior to the descending colon as seen on the longitudinal section.
From the case:
Epiploic appendagitis
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On CT this mass shows characteristic features:
- ovoid shape mass of fatty density (-60 HU)
- central hyperdense area dot, representing most likely the thrombosed vascular pedicle
- thin peripheral hyperdense rim (thickness = 2 mm)
- surrounding inflammatory fat stranding with thickening of the adjacent peritoneum
- located anterior to the descending colon
Case Discussion
Ultrasound and CT features are characteristic of an epiploic appendagitis
Additional contributor: R. Bouguelaa, MD