Presentation
Severe epigastric pain. Her physician suspects pancreatitis or pancreatic neoplasm.
Patient Data
CT scan showed a well-defined oval hyperdensity with a thin rim and engorged central vein in the lesser omentum, insinuated between the lesser curvature and the liver. It exerts mild mass effect on the lesser curvature. It's also associated with gastric mural thickening.
Normal CT appearance of the pancreas with no pancreatitis or masses.
Right hepatic lobe segment VIII hepatic focal lesion with typical marginal nodular enhancement pattern consistent with hemangioma.
CT scan showed a well-defined oval hyperdensity with a thin rim and engorged central vein in the lesser omentum, insinuated between the lesser curvature and the liver (arrows).
Case Discussion
Perigastric appendagitis is a rare inflammatory/ischemic process involving the perigastric ligaments (gastrohepatic, gastrosplenic and falciform ligaments).
Epiploic appendagitis, greater omental infarction, and perigastric appendagitis have similar mechanisms, clinical presentations, and radiological appearances.
Symptoms usually include acute and severe abdominal (epigastric) pain in absence of fever.
CT appearances consist of:
- oval heterogeneous fat density focus with mild surrounding fat stranding along the course of the gastrohepatic (anterior to the stomach), gastrosplenic (posterior to the stomach), and falciform (anterior to the liver) ligaments
Case courtesy of Dr Amir Elhamy, Lecturer of radiodiagnosis at Theodor bilharz institute, Egypt.
Unable to process the form. Check for errors and try again.