Abstract
Epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. It is a benign and self-limited condition but mimics other underlying causes of acute abdominal pain like acute diverticulitis, acute appendicitis, acute cholecystitis, etc. Inaccurate diagnosis can lead to iatrogenic adverse outcomes. To the best of our knowledge, the present report represents the first case of bilateral EA involving both cecum and descending colon. The patient presented with symptoms of bilateral iliac fossa pain. Conservative management and close outpatient follow up resulted in a successful clinical outcome with no recurrence of symptoms. This article illustrates that clinicians and radiologists should include this etiology among differential diagnoses of patients presenting with acute abdominal pain, as it might prevent unnecessary hospitalizations, antibiotic therapy, and unwarranted surgical interventions.
Highlights
Epiploic appendagitis (EA) is a rare yet benign cause of acute abdominal pain
This article illustrates that clinicians and radiologists should include this etiology among differential diagnoses of patients presenting with acute abdominal pain, as it might prevent unnecessary hospitalizations, antibiotic therapy, and unwarranted surgical interventions
We describe here the case of a young patient who presented to the ED with bilateral lower abdominal pain secondary to bilateral EA and had a successful treatment with conservative management
Summary
Epiploic appendagitis (EA) is a rare yet benign cause of acute abdominal pain. It results from the torsion of the colonic appendages, resulting in thrombosis of the draining veins and causing aseptic inflammation of the affected epiploic appendages [1,2]. His past medical and surgical history was unremarkable On physical examination, he was slightly distressed due to abdominal pain. Lipase, sodium, and potassium were within normal limits His initial abdominal ultrasound examination demonstrated probe tenderness in the right iliac fossa. An axial section of the CT abdomen and pelvis shows a second fat density structure (red arrow) anterior to the cecum with peripheral fat standing, free fluid, and adjacent cecal wall thickening (B). Radiological features of both these lesions confirmed the diagnosis of bilateral EA.
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