Presentation
Left iliac fossa pain and tenderness since 6 days. Guarding present.
Patient Data
An irregular ovoid structure of fat density measuring 33 x 23 mm is seen adjacent to the anterior wall of the sigmoid colon in left iliac fossa with a thin high density rim and surrounding inflammatory fat stranding.
Case Discussion
Epiploic appendagitis is a self-limiting inflammatory process involving epiploic appendages of the colon. This might be clinically diagnosed as acute diverticulitis and acute appendicitis depending upon the location. It is very much essential to diagnose it preoperatively to prevent unnecessary invasive procedures. Treatment is conservative and involves use of anti-inflammatory medication.
The pathogenesis is due to torsion of a pedunculated epiploic appendage, or spontaneous thrombosis of the venous outflow which may lead to ischemia and necrosis.
The patient was discharged with supportive medications. He was significantly improved at follow up after one week.
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