Diagnosing and treating epiploic appendagitis: a review of two cases

Abstract

Epiploic appendagitis (EA) is a rare condition caused by the infarction of the epiploic appendages, small outpouches of adipose tissue found on the outer surface of the bowel wall. EA results in inflammation and is often mistaken for other gastrointestinal disorders, such as diverticulitis or appendicitis. Diagnosis is primarily made through computed tomography scans, with ultrasound and magnetic resonance imaging used less often. Treatment initially involves analgesia with or without anti-inflammatory medication. However, surgery in the form of laparoscopic appendage removal may be required if symptoms persist or worsen. In total, 2 cases of EA are presented, one mimicking appendicitis and the other sigmoid diverticulitis. The purpose of the presentation is to increase awareness of EA as a cause of abdominal pain and to avoid unnecessary surgery.

Figure 1

Small intra-peritoneal ovoid fatty mass, well limited by a thin border «Ring Sign/ central dot sign», enhanced after contrast, surrounded by inflammatory changes.