Title

Acute epiploic appendagitis and its mimics

UMMS Affiliation

Department of Radiology

Publication Date

11-15-2005

Document Type

Article

Subjects

Acute Disease; Colitis; Diagnosis, Differential; Humans; *Tomography, X-Ray Computed

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

Acute epiploic appendagitis most commonly manifests with acute lower quadrant pain. Its clinical features are similar to those of acute diverticulitis or, less commonly, acute appendicitis. The conditions that may mimic acute epiploic appendagitis at computed tomography (CT) include acute omental infarction, mesenteric panniculitis, fat-containing tumor, and primary and secondary acute inflammatory processes in the large bowel (eg, diverticulitis and appendicitis). Whereas the location of acute epiploic appendagitis is most commonly adjacent to the sigmoid colon, acute omental infarction is typically located in the right lower quadrant and often is mistaken for acute appendicitis. It is important to correctly diagnose acute epiploic appendagitis and acute omental infarction on CT images because these conditions may be mistaken for acute abdomen, and the mistake may lead to unnecessary surgery. The CT features of acute epiploic appendagitis include an oval lesion 1.5-3.5 cm in diameter, with attenuation similar to that of fat and with surrounding inflammatory changes, that abuts the anterior sigmoid colon wall. The CT features of acute omental infarction include a well-circumscribed triangular or oval heterogeneous fatty mass with a whorled pattern of concentric linear fat stranding between the anterior abdominal wall and the transverse or ascending colon. As CT increasingly is used for the evaluation of acute abdomen, radiologists are likely to see acute epiploic appendagitis and its mimics more often. Recognition of these conditions on CT images will allow appropriate management of acute abdominal pain and may help to prevent unnecessary surgery.

Rights and Permissions

Citation: Radiographics. 2005 Nov-Dec;25(6):1521-34. Link to article on publisher's site

DOI of Published Version

10.1148/rg.256055030

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Radiographics : a review publication of the Radiological Society of North America, Inc

PubMed ID

16284132