Sigmoid diverticulosis and old epiploic appendagitis

Case contributed by Vikas Shah


Mild left lower quadrant ache. Previous episodes of acute pain, not investigated.

Patient Data

Age: 60 years
Gender: Male

Moderate sigmoid diverticular disease, not complicated by inflammatory change or perforation. No bowel obstruction. Incidental finding of two small structures with central soft tissue and peripheral calcification in the pelvis close to the sigmoid colon but not attached to it. These may represent old epiploic appendagitis ("peritoneal mice"). Subtle increased attenuation of central mesenteric fat with well-defined edge and fat halo around non-enlarged nodes within this portion of the mesentery, consistent with mesenteric panniculitis.

Case Discussion

Diverticulosis is a common cause of left lower quadrant symptoms. In this case, there were no complicating features such as acute inflammation or perforation. The partially calcified structures are likely to represent "peritoneal mice", a consequence of epiploic appendagitis with the detachment of the appendages from the surface of the colon.

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