What is the differential diagnosis?
Epiploic appendagitis is by far the most likely diagnosis given the rounded appearance. Omental infarction can appear similar.
What feature only seen faintly in the coronal images of this case, is helpful in confirming that this actually represents an infarcted epiploic appendix?
A central hyperdense dot representing the thrombosed vascular pedicle.
CT scan with poor contrast opacification demonstrates a fat-density ovoid mass with surrounding inflammatory stranding in the left iliac fossa. It abuts the sigmoid colon. No free fluid or free gas visible.