Presentation
Acute right lower quadrant pain, extremely tender on examination. White cell count and CRP not raised.
Patient Data
Normal cecum, terminal ileum and appendix. Well-defined oval-shaped region with thin peripheral hyperdensity and central fat attenuation with mildly streaky increased density within. No right colon diverticulosis. No free fluid or collection. Small hiatus hernia. Diffuse hepatic steatosis.
Appearances consistent with pericaecal epiploic appendagitis.
Case Discussion
Epiploic appendagitis is more commonly found in the left lower quadrant adjacent to the distal descending and sigmoid colon. It can cause severe pain and tenderness but with a relative paucity of biochemical and hematological derangement. Imaging enables a prompt diagnosis to be made, avoids unnecessary surgery, and in most instances, a safe conservative pathway may be followed, as it was in this case.
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