Learning objectives
To review the general features of this underdiagnosed benign condition.
To revise its typical imaging features in ultrasound (US) and computed tomography (CT).
To present other pathologic entities that may mimic epiploic appendagitis.
Background
Epiploic appendages are small adipose protrusions attached by a vascular stalk to the serosal surface of the colon. They frequently arise in association with colonic diverticula.
Their length is 0.5–5 cm, being the largest ones, those located near the sigmoid colon.
The most common sites of acute epiploic appendagitis, in order of decreasing frequency, are areas adjacent to the sigmoid colon, the descending colon, and the right colon.
The epiploic appendages are visible only when they are inflamed or surrounded by fluid (Fig. 1).
Each...
Findings and procedure details
EPIPLOIC APPENDAGITIS IMAGING FINDINGS:
US Imaging Findings (Fig. 2):
Ovoid mass consisting of non-compressible hyperechoic fatty tissue located in the peritoneal cavity directly under the abdominal wall, at the site of maximum tenderness, adjacent to the colon, and with no central blood flow depicted on color Doppler US images.
The absence of a Doppler signal (lack of blood flow due to the torsion of an epiploic appendage) is a useful finding to differentiate epiploic appendagitis from acute diverticulitis.
Sagittal US scanning during inspiration and expiration...
Conclusion
In conclusion, this review illustrates theimagingfeatures of a broad spectrum of diseases that maymimican epiploic appendagitis. A correct imaging diagnosisis essential as it could prevent unnecessarysurgery or hospitalization.
Personal information and conflict of interest
Y. Lamprecht; Santander/ES - nothing to disclose E. Marin; Santander/ES - nothing to disclose R. Pellon Daben; Santander/ES - nothing to disclose J. Crespo Del Pozo; Selaya, Cantabria, ESPAÑA/ES - nothing to disclose S. Sánchez Bernal; Santander/ES - nothing to disclose M. M. Acebo Garcia; Santander/ES - nothing to disclose F. J. Gonzalez; Santander/ES - nothing to disclose E. Montes Figueroa; Santander/ES - nothing to disclose J. Azcona; Santander/ES - nothing to disclose
References
Singh A, Gervais D, Hahn P, Sagar P, Mueller P, Novelline R. Acute Epiploic Appendagitis and Its Mimics. RadioGraphics. 2005;25(6):1521-1534.
C. van Breda Vriesman, Alexander J. A. Epiploic Appendagitis and Omental Infarction. The European Journal of Surgery. 2001;167(10):723-727.
Vriesman A, Puylaert J. Epiploic appendagitis and omental infarction: pitfalls and look-alikes. Abdominal Imaging. 2002;27(1):20-28.
Nadida D, Amal A, Ines M, Makram M, Amira M, Leila B et al. Acute epiploic appendagitis: Radiologic and clinical features of 12 patients. International Journal of Surgery Case Reports. 2016;28:219-222.
Almeida...