An unusual cause of acute abdominal pain: Primary appendagitis epiploica Report of two cases

Abstract

ÖZETPrimer apendajitis epiploika (PAE), kolon epiploik apandikslerinin torsiyonu ya da santral venlerinin spontan tombozu nedeniyle meydana gelen ve akut kar›n a¤r›s›na yol açan ender bir hastal›kt›r. Genellikle cerrahi müdahale gerektirmeyen ve kendini s›n›rlayac› özellikte bir hastal›k olsa da, cerrahi giriflimin ya da agresif medikal tedavinin flart oldu¤u apandisit, divertikülit, kolesistit gibi akut kar›n hastal›klar›n› taklit edebilir. Gereksiz cerrahi giriflim ve hastane yat›fllar›n›n önlenmesi için PAE olgular›n›n do¤ru teflhis edilmesi büyük önem tafl›maktad›r. Bu yaz›da, akut kar›n a¤r›s› nedeniyle de¤erlendirilen ve primer apendajitis epiploika tan›s› alan iki olgu sunulmaktad›r.Anahtar Kelimeler: Apendajitis, Apandisit, Divertikülit, Akut kar›n ABSTRACT Primary appendagitis epiploica (PAE) is a rare disease due to torsion or spontaneous thrombosis of the central draining vein of the colon and causes acute abdominal pain. PAE is a self limiting disease and it doesn't usually require surgical intervention. But it can mimic conditions such as appendicitis, diverticulitis, cholecystitis that definitely need surgical interventions or agressive medical treatment. Because of this, the correct diagnose of PAE is very important in order to prevent unnecessary surgical interventions or hospitalisations. In this paper, we present two patients that examined because of acute abdominal pain and then diagnosed with PAE.

An unusual cause of acute abdomen – epiploic appendagitis: report of two cases

“…Although they are more diffuse in sigmoid colon (57%), and ileocecal region (26%) only 50–100 epiploic appendages are seen in the whole colon [3, 4]. They are perfused by one or two small terminal branches of colonic vasa recta, and drained through a single vein.…”

“…Generally it encounters us as localized lower quadrant pain with sudden onset. Sharp pain can be demonstrated specifically [4]. However tenderness, and localized guarding can occur without rigidity [7].…”

“…However omental metastases confront us with soft tissue implants on the peritoneal surface. Omental cake is seen as a thick soft tissue mass adjacent to the ventral aspect of the transverse colon [4]. CT is a noninvasive tool which enables us to make a differential diagnosis among all these diseases.…”