This case demonstrates the typical appearance and location of epiploic appendagitis, where there is either torsion of an epiploic appendage or spontaneous thrombosis of the epiploic appendage central draining vein. It can be primary or secondary to an adjacent inflammatory process. It can affect any part of the colon, but is most common in the sigmoid and descending colon, likely due to the distribution of the appendages.
The diagnosis has become more common with the routine use of CT for the investigation of abdominal pain. Epiploic appendagitis on the left side is in the differential for LIF pain, along with the more common sigmoid diverticulitis. Epiploic appendagitis on the right side is in the differential for RIF pain, along with the more common acute appendicitis.
Management is conservative with NSAIDS and analgesia. Rarely is there a need for surgical management.