Presentation
Upper abdominal pain, afebrile.
Patient Data
There is an ovoid central area of preserved fat, surrounded by mild fatty stranding is noted at the right upper quadrant, in the left subhepatic area is seen along the course of the falciform ligament (anterior to the liver), suggestive of perigastric appendagitis rather than focal omental infarction.
Normal appearance of liver, GB, CBD, pancreas, spleen, both kidneys, adrenals, visualized bowel loops, urinary bladder.
No significant lymphadenopathy is detected.
No free fluid/air or localized collection is detected.
Both lung bases are clear.
The visualized parts of the bones show no evidence of destructive lesions.
IMPRESSION:
The CT finding is suggestive of perigastric appendagitis rather than focal omental infarction.
Case Discussion
Perigastric appendagitis is a rare entity, it may be an under-reported entity. It should be considered in cases of upper abdominal pain where no other causes have been found, especially when blood tests are normal.