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01 October 2011

Epiploic appendagitis in a 27-year-old man

Ryohei UeharaBC, Hajime IsomotoADEF, Naoyuki YamaguchiB, Ken OhnitaB, Fumihiko FujitaB, Tatsuki IchikawaB, Fuminao TakeshimaC, Tetsuji YamaguchiB, Masataka UetaniD, Kazuhiko NakaoF

DOI: 10.12659/MSM.881968

Med Sci Monit 2011; 17(10): CS113-115

Abstract

Background: Epiploic appendagitis is an ischemic infarction of an epiploic appendage caused by torsion or spontaneous thrombosis of the central draining vein. Epiploic appendagitis is self-limited without surgery, and it is imperative for clinicians to be familiar with this entity.
Case Report: A healthy 27-year-old man was admitted due to acute right lower quadrant abdominal pain. Physical examination showed focal abdominal tenderness with slight rebound tenderness. Laboratory tests showed leukocytosis and an increased serum C-reactive protein level. Computed tomography (CT) showed a fatty ovoid pericolonic mass measuring 12 mm in diameter, with a circumferential hyperdense ring that abutted on the ascending colon and was surrounded by ill-defined fat stranding with a hyperdense ring. These findings were diagnostic of primary epiploic appendagitis. The patient was given high-dose antibiotics due to the secondary inflammation involving the parietal peritoneum.
Conclusions: Epiploic appendagitis presents with an abrupt onset of focal abdominal pain and tenderness without significant guarding or rigidity; it is an uncommon and difficult diagnosis. With awareness of this condition, however, evaluation by CT can provide an accurate diagnosis of epiploic appendagitis, distinguishing it from conditions with clinically overlapping manifestations.

Keywords: Phenylpropionates - therapeutic use, Leukocyte Count, Colon, Ascending - pathology, C-Reactive Protein - analysis, Adipose Tissue - radiography, Abdomen, Acute - etiology, Tomography, X-Ray Computed, Torsion Abnormality - diagnosis

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750