Value of laparoscopy in appendix epiploica infarction – A report of four cases

Abstract

Inflammation of the appendix epiploica is a rare condition which may lead to torsion and eventually infarction. It is almost always never diagnosed clinically. Our four patients were young females presenting with right lower quadrant abdominal pain and nausea. The white cell counts were marginally elevated in all four patients. Clinically, we suspected appendicitis or Meckel’s diverticulitis. Laparoscopy revealed a normal appendix with infarction of the epiploic appendix which was easily excised using ultracision shears. The appendix epiploica has no known function. Inflammation of the appendix epiploica is called appendagitis. Appendagitis and torsion will mimic appendicitis or acute abdomen. This condition usually responds to antibiotic therapy, but surgery is indicated if infarction occurs. There are very few reports of laparoscopy in surgery for appendix epiploica. Our patients were managed laparoscopically with a good outcome. The benefits of laparoscopy include avoidance of laparotomy and reduced morbidity.