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- Title
Cecal Epiploic Appendagitis: A Diagnostic and Therapeutic Dilemma.
- Authors
Patel, Vijaykumar G.; Rao, Arundathi; Williams, Reginald; Srinivasan, Radha; Fortson, James K.; Weaver, William L.
- Abstract
Acute epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. Though a benign and often self-limiting condition, EA's ability to mimic other disease processes makes it an important consideration in patients presenting with acute abdominal symptoms. Careful evaluation of abdominal CT scan findings is crucial in the accurate diagnosis of epiploic appendagitis, thus avoiding unnecessary surgical intervention. We report a case of a 29-year-old male presenting with a two day history of generalized abdominal pain. Physical exam revealed a diffusely tender abdomen with hypoactive bowel sounds. The patient had a leukocytosis of 18,000 and abdominal CT scan revealed right lower quadrant inflammatory changes suggestive of acute appendicitis. Laparoscopic exploration revealed an inflamed gangrenous structure adjacent to the ileocecal junction. Pathologic evaluation revealed tissue consistent with epiploic appendagitis. Retrospective review of the CT scan revealed a normal appearing appendiceal structure superolateral to the area of inflammation. The patient recovered uneventfully with resolving leukocytosis. We present a case of cecal epiploic appendagitis mimicking acute appendicitis and review the current literature on radiographic findings, diagnosis, and treatment of this often misdiagnosed condition. General surgeons should be aware of this self-limiting condition and consider this in the differential diagnosis.
- Subjects
APPENDIX diseases; ABDOMINAL pain; LEUCOCYTOSIS; APPENDICITIS; MEDICAL radiography
- Publication
American Surgeon, 2007, Vol 73, Issue 8, p828
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/000313480707300821