Epiploic appendagitis

Case contributed by Vikas Shah


Left iliac fossa pain. Tender on examination. Scan for diverticulitis.

Patient Data

Age: 35 years
Gender: Male

CT abdomen and pelvis


No diverticulosis or diverticulitis. Oval fat density structure adjacent to sigmoid colon with peripheral enhancement and central dot but otherwise no central inflammation. Streaky increased attenuation of the surrounding fat with thickening of the overlying peritoneum. No fluid collection. 

Annotated image

Red arrow indicated inflamed appendix epiploica adjacent to sigmoid colon, with hyperattenuating ring sign and peritoneal inflammation.

Case Discussion

Epiploic appendagitis is a cause of acute abdominal pain and mimics other diseases depending on the location; in this case, it mimicked diverticulitis due to the location in the left iliac fossa. The majority of cases are managed conservatively. Epiploic appendagitis falls under the umbrella of intraperitoneal focal fat infarction, and other entities also under this umbrella include omental infarction.

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