Epiploic appendagitis and uterine agenesis

Case contributed by Dr Bassem Marghany

Presentation

Localized left lower abdominal pain for 1 week; the patient has never had a menstrual cycle.

Patient Data

Age: 20 years
Gender: Female

Small ovoid lesion related to the left lateral aspect of the descending colon, adherent to its outer wall (extra-luminal), exhibiting central fat density with a hyperdense dot within, surrounded by a high-density rim and subtle fat stranding; Findings are impressive of epiploic appendagitis.

No uterus could be detected in its normal anatomical position.

Both ovaries are seen in their normal anatomical position.

Case Discussion

The patient presented with localized abdominal pain at the left iliac fossa for 1 week.

In epiploic appendagitis, the pain is usually more localized (usually pointing to the lesion) than with other causes of acute abdomen. The condition is mostly self-limiting and correct diagnosis spares the patient unnecessary surgery.

The patient was previously diagnosed with uterine agenesis a few years back. Uterine agenesis with congenital absence of the upper vagina, in the presence of normal ovaries, represents the typical form of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.  

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