Epiploic Appendigitis – Presenting as Acute Abdomen: Diagnostic Pitfalls and Clinical Insights

Hooria Hafeez¹, Huma Aslam², Aneel Kumar³, Imran Qureshi⁴, Hamed Sultan Albusaidi⁴, Parmanand Nathani⁴, Fatema Mohammed Khamis Al Sadairi⁴, Sanobar Bughio^5*, Omar Rashid Al Hatmi⁶, Jaweria Naqi^7
1Macclesfield District General Hospital, Victoria Rd, Macclesfield SK10 3BL, UK.
²South Tynside and Sunderland NHS foundation Trust UK.
³Specialist Radiologist, King's College Hospital London, Dubai UAE.
⁴Department of Radiology, Royal Oman Police Hospital, Oman.
⁵Specialist Radiologist, Royal Oman Police Hospital, Oman.
⁶Senior Medical Officer, Royal Oman Police Hospital, Oman.
⁷Shaheed Mohtrma Benazir Bhuto Medical college, Lyari, Karachi, Pakistan.

Correspondence to: Sanobar Bughio, Specialist Radiologist, Royal Oman Police Hospital, Oman.
Received date: October 11, 2024; Accepted date: October 24, 2024; Published date: October 31, 2024
Citation: Hafeez H, Aslam H, Kumar A, et al. Epiploic Appendigitis – Presenting as Acute Abdomen: Diagnostic Pitfalls and Clinical Insights. J Med Res Surg. 2024;5(5):121-123. doi: 10.52916/jmrs244150
Copyright: ©2024 Hafeez H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Epiploic appendigitis is a rare, benign, self-limiting inflammatory process of the epiploic appendices. The epiploic appendices are small pouches of the peritoneum filled with fat and situated along the colon, mainly the transverse and sigmoid parts, but are absent in the rectum and have an unknown function. These appendages can become acutely inflamed as a result of torsion or venous thrombosis.
Case Report: A young patient came to emergency department of our hospital with complain of pain in abdomen at left lumber region since five days. On Physical examination revealed lump at left lumber region at the site of pain. Further investigated by radiological.
Discussion: Epiploic appendigitis is an uncommon condition first described by Lynn et al in 1956 and is one of the rare causes of acute abdomen secondary to the inflammation and necrosis of small finger like projections along the colon. These appendages refer to adipose structures that rise in the surface of the colon and project into the abdominal cavity.
Conclusion: Given the rarity of this condition, its elusive nature and tendency to mimic acute appendicitis, diverticulitis or cholecystitis, which all may require surgical intervention, it is increasingly apparent that we should educate medical professionals on this important differential diagnosis, as early and accurate diagnosis can prevent unnecessary invasive treatments and misdiagnosis.

Keywords:

Epiploic appendigites, CT scan, Ultrasound, Treatment.

References

1. Gaillard F, Sharma R, Geravandi M, et al. Epiploic appendagitis. Radiopaedia.org.
2. Mert A, Mırcık E. Primary Epiploic Appendagitis: A Case Report. Cureus. 2021;13(3):e14060.
3. Gamboa-Hoil SI, Y.G. De la Paz-Ponce YG, Pat-Cruz F, et al. Appendagitis acute, a rare cause of abdominal pain: A case report. Rev Med Hosp Gen (Mex). 2018;81(S1):47-50.
4. Mert A, Mırcık E. Primary Epiploic Appendagitis: A Case Report. Cureus. 2021;13(3):e14060.
5. Huang K, Waheed A, Juan W, et al. Acute epiploic appendagitis at the tip of the appendix mimicking acute appendicitis: A rare case report with literature review. World J Gastrointest Surg. 2019;11(8):342-347.
6. Sand M, Gelos M, Bechara FG, et al. Epiploic appendagitis-clinical characteristics of an uncommon surgical diagnosis. BMC Surg. 2007;7:11.
7. Guo L. Osmosis - epiploic appendagitis: What is it, causes, diagnosis, and more; 2022.
8. Wikipedia Contributors. Epiploic appendagitis [Internet]. Wikipedia. Wikimedia Foundation; 2019.