Epiploic appendagitis

Q: What additional diagnoses should be considered given the history? show answer

A: Common causes of left iliac fossa pain include diverticulitis and adnexal pathology in a female patient. Other considerations would include atypical appendicitis, paracolic abscess, perforation or partial bowel obstruction, e.g intususseption.

Q: Where is the abnormality? show answer

A: The pathology is centred on the proximal-sigmoid colon. There is fat-stranding and a small amount of adjacent free fluid. Multiple diverticula are seen.

Q: What is the diagnosis? show answer

A: The fat-stranding is centered on the fat-density lesions that sit on the lateral wall of the sigmoid colon, not on the diverticula (of which there are many). The ovoid fat-density lesions with central high attenuation sitting on the lateral margin of the sigmoid colon represent epiploic appendagitis.

Q: What does the high density central focus represent? show answer

A: The thrmobosed vessel of the epiploica.