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Answer: A. Oral anti-inflammatory medication


Epiploic appendagitis

  • Benign self-limited cause of acute abdominal pain
  • Characteristic CT findings: pericolonic oval, fat-attenuation lesion with surrounding inflammatory changes
  • Presentation may mimic acute diverticulitis or appendicitis
  • Treatment with nosteroidal anti-inflammatory medication

Epiploic appendages are peritoneal outpouchings composed of adipose tissue arising from the serosal surface of the colon, to which they are attached by a vascular stalk. Acute epiploic appendagitis is a rare, self-limited inflammation of the appendices epiploicae that may be a result of torsion or venous occlusion. The most common presentation is acute lower quadrant pain and it may simulate acute diverticulitis or appendicitis. Accurate diagnosis is important to avoid unnecessary hospitalization and treatment. CT features include an oval lesion up to 5 cm in length, attenuation similar to fat, and surrounding inflammatory changes. Most cases occur adjacent to the sigmoid colon, although it can affect any part of the colon. Treatment is conservative with oral nonsteroidal anti-inflammatory medication. Antibiotics are not routinely indicated. Most patients recover with conservative management in less than 10 days.

References

Rioux M, Langis P. Primary epiploic appendagitis: Clinical, US, and CT findings in 14 cases. Radiology. 1994;191:523-526.

Singh AK, Gervais DA, Hahn PF, Sagar P, Mueller PR, Novelline RA. Acute epiploic appendagitis and its mimics. Radiographics. 2005 Nov-Dec;25(6):1521-1534.


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