Acute Epiploic Appendagitis: An Overlooked Cause of Acute Abdominal Pain

Abstract

Acute epiploic appendagitis is a benign condition caused by inflammation of the epiploic appendages that are serosal lined outpouchings of the colon lying adjacent to the tenia coli. This rare condition has non-specific clinical findings and is frequently misdiagnosed as either acute diverticulitis or acute appendicitis. However, unlike other surgical causes of acute abdomen, epiploic appendagitis is a self-limited condition and resolves with conservative management. CT of the abdomen plays a vital role in diagnosing this condition and excluding other causes of acute abdomen. This case report highlights the importance of being aware of this rare condition and its consideration in the differential diagnosis of acute lower abdominal pain to avoid unnecessary hospitalization and surgery.

Keywords: acute abdomen; diverticulitis mimic; epiploic appendagitis; left iliac fossa pain; left lower quadrant pain; left-sided abdominal pain; rare cause of acute abdominal pain.

Figure 1. (A) Axial, (B) coronal, and (C) sagittal non-contrast CT images showing a fat-containing nodule adjacent to the descending colon with surrounding inflammatory stranding (arrows).