March 16, 2009

Epiploic Appendagitis

An axial CT image of a 43-year-old man with left lower quadrant pain shows an oval fatty mass (arrow) with surrounding fat stranding. There is fascial thickening (arrowheads).

Epiploic Appendagitis

  • Torsion of epiploic appendages results in vascular occlusion, leading to ischemia
  • Inflammation of appendages is self limited. Rarely, it may result in adhesion, bowel obstruction, peritonitis, or abscess
  • Common in 4th to 5th decades of life
  • Acute pain, most in left lower quadrant - easily mistaken for acute diverticulitis
CT Appearance
  • Anterior to colonic lumen, sigmoid colon > descending colon > cecum
  • Oval fatty mass surrounded by inflammation, 1.5cm and 3.5cm size
  • Central high-density focus represents venous thrombosis
  • Colonic wall thickening rare

Singh AK. CT appearance of acute appendagitis. AJR Am J Roentgenol 2004;183:1303-1307.

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