Epiploic appendagitis - sigmoid colon

Case contributed by Ammar Haouimi
Diagnosis almost certain


Left lower abdominal pain.

Patient Data

Age: 55 years
Gender: Male

The CT scan shows the following features:

  • ovoid structure of fat-density in the left iliac fossa, adjacent to the sigmoid colon measuring (3.5 x 3.4 x 2 cm)
  • thin peripheral high-density rim "hyperattenuating ring sign" 
  • no significant thickening of the adjacent colonic wall
  • surrounding inflammatory fat stranding with thickening of the adjacent peritoneum
  • central hyperdense dot is noted, representing most likely the thrombosed vascular pedicle

Hiatus hernia is noted.

Case Discussion

CT scans showing the classic features of an epiploic appendagitis of the sigmoid colon.

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