A case report of epiploic appendagitis as a mimic of acute cholecystitis

Abstract

HighlightsEpiploic appendagitis can mimic acute cholecystitis and other common causes of abdominal pain.Epiploic appendagitis should be included in the differential of acute abdominal pain.Epiploic appendagitis is initially managed conservatively with analgesia and anti-inflammatories.

Acute epiploic appendagitis: ultrasound and computed tomography findings of a rare case of acute abdominal pain and the role of other imaging techniques

“…Unlike its mimics, EA is a self-limiting inflammatory condition and generally requires conservative treatment [3,7,12,20]. For these reasons, radiologists' knowledge and awareness of EA as a cause for abdominal pain and its radiographic findings can prevent unnecessary hospitalisation and surgery [1,7].…”

“…Epiploic appendagitis (EA), also known as appendicitis epiploicae, epiplopericolitis, or appendagitis, is a relatively rare, benign, and local inflammatory disease involving the epiploic appendices [1][2][3][4].…”

“…This disease typically affects people aged 20-50 years, with a greater frequency in men than in women (4 : 1) [1,[17][18][19][20].…”

“…Primary EA is an inflammatory disease that may arise from a spontaneous torsion causing obstruction of blood flow within the omental appendage, then ischaemia up to a necrosis, or from spontaneous thrombosis of the draining vein and inflammation [13,15,21]. Instead, secondary EA may arise from adjacent inflammatory diseases involving the colonic wall and surrounding mesocolon, such as diverticulitis or appendicitis [1,12].…”

“…Unlike its mimics, EA is a self-limiting inflammatory disease in most patients, with an average of 10 days, and can be treated conservatively, only with anti-inflammatory medication [1,3,11]; rarely it may cause the development of adhesion, bowel obstruction or intussusception, intra-peritoneal loose body (peritoneal "mice"), peritonitis, and abscess [1,11]. For these reasons, it is very important to differentiate EA from the other diseases causing abdominal pain, such as acute appendicitis, which usually require surgery [1,8].…”