Apendagite epiplóica: tratamento conservador

Pignaton, Gustavo; Borges, Adriana de Almeida; Mendonça, Renato Gonçalves de; Ribeiro, Cláudia; Chindamo, Maria Chiara

doi:10.1590/s0101-98802008000300015

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…The diagnosis is made by CT of the abdomen, and this condition should be treated clinically, with analgesics and anti-inflammatory drugs. 28 Omental infarction is usually caused by torsion of the omentum or disturbances in the vascular supply. 29 Its clinical presentation is similar to that of acute appendicitis, and the diagnosis is made by abdominal CT or intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

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Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?

Sobrado

Caldas

Facanali

et al. 2022

Journal of Coloproctology

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Introduction Right colon diverticulitis (RCD) is an uncommon condition in Western populations, but its incidence has increased over the last decades. Due to its rarity, many surgeons are unfamiliar with this disease, which is often mistakenly diagnosed as acute appendicitis. The lack of data about the diagnosis and management of RCD in Western populations makes it difficult to establish the optimal therapeutic strategy. Objective To evaluate the outcomes of patients treated for acute RCD and to propose a therapeutic algorithm for the diagnosis and treatment. Methods A retrospective analysis of the medical records of patients treated for acute RCD between 2008 and 2020 by a single experienced colorectal surgeon was performed. Results In total, 12 patients were identified, 8 male and 4 female subjects, with a mean age of 49.6 years; 9 of these patients were of Western origin. The median follow-up time was of 49 months (range: 12 to 144 months). The most frequent symptoms were abdominal pain (100%) and fever (66%). Diagnostic errors in imaging exams occurred in four patients. A total of 6 patients were managed clinically, and the other 6 underwent surgical treatment with right colectomy (n = 5) and total colectomy (n = 1), 2 via laparoscopy and 4 through a laparotomy. The anatomopathological examination confirmed RCD in all operated patients. There was no incidental finding of neoplasia and there were no deaths during the study period. Conclusion Uncomplicated RCD can be treated conservatively with a high success rate. Recurrent cases that impact quality of life or complicated forms of RCD should undergo surgical treatment, preferably through a right laparoscopic colectomy. The authors present a diagnostic and therapeutic algorithm to facilitate the diagnosis and to guide the management of this uncommon disease.

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Section: Discussionmentioning

confidence: 99%

“…The diagnosis is made by CT of the abdomen, and this condition should be treated clinically, with analgesics and anti-inflammatory drugs. 28…”

Section: Discussionmentioning

confidence: 99%

Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?

Sobrado

Caldas

Facanali

et al. 2022

Journal of Coloproctology

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“…The main clinical symptom mentioned in PEA is the presence of acute abdominal, localized pain, of sudden onset (usually lasting less than a week), continuous and intense, commonly felt in the left lower quadrant of the abdomen, of non-migratory character, which affects a patient who is in good overall condition. 15 As in the two cases described, the patient can easily identify the most painful site. A retrospective study showed that the pain has a non-migratory character, affecting the lower quadrants of the abdomen (41.9%) and the upper and lower hypogastrium at lower percentages (9.7% and 6.5%, respectively).…”

Section: A B a Bmentioning

confidence: 91%

“…A retrospective study showed that the pain has a non-migratory character, affecting the lower quadrants of the abdomen (41.9%) and the upper and lower hypogastrium at lower percentages (9.7% and 6.5%, respectively). 5,15 Pain is more common in the lower left quadrant of the abdomen (73%-93%) when compared to the right (7%-21%) or in the epigastrium (2% to 5%), probably due to the greater presence of EA in the sigmoid colon. 1,4,5 Symptoms such as change in stool frequency (19.4%), fever (15%), nausea (12.9%), anorexia (9.7%) and vomiting (3.2%) are less common.…”

Section: A B a Bmentioning

confidence: 99%

Primary epiploic appendagitis

Palma

Júnior

Sato

et al. 2013

Journal of Coloproctology

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Primary epiploic appendagitis (PEA) is a seldom reported disease caused by spontaneous torsion of one or more epiploic appendices. The aim of this study is to describe two cases of PEA reviewing the main aspects of the diagnosis and treatment of disease. Case report: Case 1) Male patient, 55 years old, obese, with abdominal right iliac fossa (RIF) pain for two days. Abdominal examination showed pain on palpation in the RIF with rebound tenderness. Abdominal computed tomography identified lobulated lesion in the cecum, measuring 4.5 cm in diameter, which was suggestive of PEA or early neoplasm of the colon wall. The laparoscopic assessment confirmed the diagnosis of PEA and the appendix was removed. The patient had a satisfactory outcome, being discharged on the second postoperative day. Case 2) Female patient, obese, 47 years old, with abdominal pain for six days, with sudden RIF onset. She had pain at palpation with rebound tenderness. Acute diverticulitis was suspected and patient underwent abdominal CT that identified PEA in the sigmoid colon. After expectant management, the patient showed progressive improvement resuming her activities in seven days. PEA is a rarely recalled condition during the investigation of inflammatory acute abdomen which can be easily recognized by modern imaging methods of assessment.

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Clinical, diagnostic and therapeutic aspects of the epiploic appendagitis

Cossiolo¹,

Sahyun²,

Silva³

et al. 2018

IJRRT

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Background: The Epiploic Appendagitis is an uncommon pathology arising from the torsion or spontaneous venous thrombosis of the veins responsible for the drainage of the apoptotic appendages. Aim: The purpose of this research is to report the characteristics of this disease. Method: The review includes articles published in papers indexed in the Scielo and PubMed databases over the last eight years (2008-2016). The following headings were crossing: Epiploic Appendagitis, differential diagnosis of Appendagitis and diagnostic methods of Appendagitis, and their respective literal translations in English, were selected 26 articles, used for database. Results: Although there is discordance in the literature, the male sex is more frequently affected by this pathology. The characteristic manifestation is acute non-migratory abdominal pain, most often located in the lower left quadrant of the abdomen. The diagnosis is made from images from the Computed Tomography. The treatment occurs outpatient and provides for administration of analgesic and anti-inflammatory. Conclusion: A correct initial approach avoids invasive and unnecessary procedures

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Apendagite epiplóica: tratamento conservador

Cited by 4 publications

References 7 publications

Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?

Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?

Primary epiploic appendagitis

Clinical, diagnostic and therapeutic aspects of the epiploic appendagitis

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