Primary epiploic appendagitis (PEA) is a rare case of acute abdomen pain and can be often misdiagnosed with diverticulitis or appendicitis,
because of the absence of specific symptoms.
Because of the benign self-limited course of PEA,
it is important to recognise and understand its manifestations,
in order to avoid unnecessary surgery and hospitalization.
The diagnosis of this condition relies firstly on multidetector CT ( MDCT).
In this poster we illustrate the spectrum of CT findings in patient with PEA and its complications.
Our aim is...
Methods and Materials
Seven patients (2 females,
5 males; range 12 to 60 years) with acute abdominal pain were included in our study.
All patients underwent MDCT scan (16 rows for 4 patients and 128 rows for 3 patients) before and after iodinated contrast medium administration (320 mgI\ml).
Images were evaluated at dedicated work-station using axial images and multi-planar reconstructions (MPR).
The CT scans of the epiploic appendagitis were evaluated for a focal fatty center,the presence of colon wall thickening,
location in relationship to the colon,...
Epiplooic appendages are fatty appendages originating in two rows parallel to the toenia coli.
Their limited blood supply together with their pedunculated shape and excessive mobility make them prone to torsion and ischemic infarctions.
PEA refers to inflammation in the epiplooic appendages caused by spontaneous torsion of its vascular stalk.
All patients came to our attention with acute abdominal pain: 5 patients had left lower quadrant pain,
2 patients right lower quadrant pain.
All patients were afebrile and only 4 showed mild leukocitosis.
PEA is very rare and because of non specific symptoms and signs,
it is often misdiagnosed: today this condition can be well recognised with a good confidence with MDCT.
The most common CT features we found is an oval lesion less than 5 cm that has an attenuation equivalent to that of fat,
that abuts the anterior colonic wall and that is surrounded by inflammatory changes.
Thickening of the parietal peritoneum and of the colonic wall also may be observed.
Inflammation of epiplooic appendages in...
CT Appearance of Acute Appendagitis.AK Singh,
PF Hahn et al.AJR November 2004 183:1303-1307.
Epiploic Appendagitis: An Entity Frequently Unknown to Clinicians Diagnostic Imaging,
Pitfalls and Look- Alike.
B Viamonte et al.
AJR 2009; 193:1243–1251.
Clinical characteristics of primary epiploic appendagitis.
Korean Soc Coloproctol 2011;27(3):114-121
Acute Epiploic Appendagitis and Its Mimics.
PF Hahn et al.
RadioGraphics 2005; 25:1521–1
Beyond appendicitis: common and uncommon gastrointestinal causes of right lower quadrant abdominal...