Epiploic Appendagitis in a Young Adult Female: A Rare Cause of Acute Abdominal Pain

Abstract

Epiploic appendagitis (EA) is an uncommon and frequently misdiagnosed cause of acute abdominal pain, typically affecting middle-aged males. This case report presents an atypical occurrence in a 32-year-old Hispanic female who presented with left lower quadrant pain, initially suspected to be diverticulitis or infectious colitis. Contrast-enhanced CT imaging revealed the characteristic findings of EA, a diagnosis that is rarely seen in young adult females. The patient was successfully treated through conservative measures and avoided unnecessary surgical interventions. This case emphasizes the importance of considering EA in the differential diagnosis of acute abdominal pain across diverse patient demographics. It also highlights the crucial role of contrast-enhanced CT imaging to accurately diagnose and treat EA. By increasing awareness of this condition among clinicians, we can improve diagnostic accuracy, reduce unnecessary interventions, and optimize patient care in cases of acute abdominal pain.

Keywords: acute abdominal pain; conservative management; ct imaging; epiploic appendagitis; gastrointestinal disorders; inflammatory conditions; misdiagnosis; young female.

Figure 1. Axial contrast-enhanced CT image of the abdomen in a 32-year-old Hispanic female presenting with left lower quadrant pain

The image demonstrates a characteristic oval-shaped fat-density lesion (red arrow) adjacent to the sigmoid colon. The lesion is surrounded by a hyperattenuating ring, consistent with the diagnosis of EA. Note the inflammatory changes in the surrounding fat, indicative of local inflammation. This imaging finding, often referred to as the "central dot sign," is pathognomonic for EA and crucial for differentiating it from other causes of acute abdominal pain.

Figure 2. Coronal contrast-enhanced CT image of the abdomen in a 32-year-old Hispanic female presenting with left lower quadrant pain

The image demonstrates a characteristic oval-shaped fat-density lesion (red arrow) adjacent to the sigmoid colon. The lesion is surrounded by a hyperattenuating ring, consistent with the diagnosis of EA.