Epiploic appendagitis - sigmoid colon

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Three days history of left lower pelvic pain.

Patient Data

Age: 55 years
Gender: Female
ultrasound
Longitudinal
Transverse
Long-colour
Doppler
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Info

There is an ill-defined non-compressible, hyperechoic mass (4 x 3.5 cm) adjacent to the wall of the sigmoid colon, with no internal vascularity on colour Doppler.

This study is a stack
Axial
non-contrast
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
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Info

There is an ovoid structure of fat-density, in the left iliac fossa,  adjacent to the sigmoid colon with thin peripheral hyperdense rim ( hyperattenuating ring sign) and surrounding inflammatory fat stranding. Minimal and regular thickening of the adjacent sigmoid wall is noted.

A Riedel lobe is noted.

Case Discussion

Ultrasound and CT features of an epiploic appendagitis

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