EPIPLOIC APPENDAGITIS: AN UNCOMMON CASE OF ACUTE ABDOMINAL PAIN WITH CHARACTERISTIC IMAGING FINDINGS.

Abstract

Introduction: th th Epiploic appendagitis is an uncommon cause of abdominal pain and is frequently undiagnosed. Obese men in their 4 and 5 decade of life are most affected. It generally mimics other serious causes of acute abdomen and thus the denitive diagnosis relies on cross-sectional imaging primarily computed tomography ndings. Most often the condition is caused due to torsion of an epiploic appendage or spontaneous venous thrombosis of a draining appendageal vein. Appendices epiploicae are small (0.5-5 cm long), fat lled pouches of peritoneum projecting from the external surface of colon and are supplied by blood vessels that protrude through the bowel wall. They are present commonly over distal colon particularly numerous at the rectosigmoid junction. Case: We are reporting a case of 42 years old male patient, who presented to the surgical OPD at Dr. RPGMC Tanda with chief complaint of acute abdominal pain localized in the left iliac fossa with tenderness in the region. The ultrasonography report was inconclusive and the patient was further evaluated using biochemical investigations and contrast enhanced CT of the abdominopelvic region. The CECT revealed fat dense ovoid shaped lesion in the left iliac fossa with surrounding fat stranding and hyperdense rim suggestive of intraperitoneal focal fat infarction. The condition was managed conservatively with empirical antibiotics and analgesics. Conclusion: Epiploic appendagitis is a self-limiting disease but persistence of symptoms or recurrence requires surgical management with laparoscopic appendage excision. The anatomical and surgical knowledge of epiploic appendagitis is very important to raise awareness about this clinical condition and to manage it appropriately.