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Case of the Week 346



What's the most likely diagnosis?

  • 41 year-old with left lower quadrant pain



Axial CT of Lower Abdomen

  1. Colonic polyp
  2. Shock bowel
  3. Pneumoperitoneum
  4. Epiploic appendagitis
  5. Absence of the kidneys

Additional Image - Another axial CT slice of lower abdomen

 

Additional Image

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Axial CT of Lower Abdomen

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Answer:

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4. Epiploic Appendagitis

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More (Click Discussion Tab)


Epiploic Appendagitis


General Considerations

  • Uncommon cause of acute abdominal pain
  • Occurs most often in men in 4th and 5th decade
  • Inflammation of epiploic appendages (appendices)
    • Peritoneal outpouchings originating from serosal surface of colon
      • Contain blood vessels and fat
  • Diagnosis requires cross-sectional imaging
  • Inflammation may be caused by venous occlusion
  • “Secondary” epiploic appendagitis is caused by inflammation of an adjacent structure

 

    More ...


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