Epiploic appendagitis mimicking acute appendicitis

Case contributed by Ammar Ashraf


Severe right lower abdominal pain for 2 days. No fever, vomiting or change in bowel habits.

Patient Data

Age: 30 years
Gender: Male

Small fat density ovoid structure adjacent to the cecum, with inflammatory changes/fat stranding in the right iliac fossa, consistent with epiploic appendagitis. No colonic diverticula or features of acute appendicitis. Few tiny renal calculi, enlarged fatty liver (19 cm) and small fat containing umbilical hernia.  

Histopathology of the appendectomy: Negative for acute appendicitis. 

Histopathology of the excised epiploic appendage: Fat necrosis with interstitial hemorrhage and vascular congestion.

Case Discussion

Sometimes, epiploic appendagitis can mimic acute appendicitis, like this case, in which unfortunately, initially the CT scan findings were interpreted as acute appendicitis. The patient underwent laparoscopic surgery which however, showed normal looking appendix and epiploic appendagitis and these surgical findings were later confirmed by the histopathology. 

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