Epiploic appendagitis

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain


Acute onset of right iliac fossa pain and tenderness.

Patient Data

Age: 40 years
Gender: Female

A small ovoid well defined fat-density lesion, with a prominent enhancing wall giving hyperattenuating ring sign (that differentiates it from omental infarct) and adjacent inflammatory fat stranding, is seen adherent to the anterior wall of the proximal sigmoid colon within the right side of the pelvis denoting acute epiploic appendagitis.

Case Discussion

Epiploic appendagitis enters in differential diagnosis with acute appendicitis, differentiating both lesions is mandatory as the latter requires immediate surgical intervention while the other is always treated conservatively. Another DD is with an omental infarct which is also a part of intraperitoneal focal fat infarction (IFFI).

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