Apendicitis epiploica: la otra apendicitis

Unusual course of epiploic appendicitis

“…Epiploic appendicitis was first described in 1956 by Lynn and it is a cause of acute abdomen in 0.6% of the cases. It predominates in the second and fifth decade, with a similar incidence in both sexes and can be primary or secondary (1)(2)(3). The secondary form is the most common and it happens when the appendix tries to form a plastron around a swollen structure (appendicitis, diverticulitis) to limit inflammation (5).…”

“…When it is on the right lower quadrant it may mimic acute appendicitis, but pain is better located and more cranial than in appendicitis. It is a local process, without malaise or constitutional syndrome in most cases (3,4). Only 25% of the patients have changes in their bowel habits, usually constipation.…”

“…Fever is exceptional and in 25% of the cases there is febricula. Clinical examination reveals pain predominantly in the left abdomen with peritoneal irritation if there is involvement of the parietal peritoneum with mass presentation in 10-30% of the cases (3,4). Laboratory values are within normal limits, except for slight leukocytosis and elevated acute phase reactants.…”

“…Ultrasound is usually the first exploration due to its availability and no radiation (7), but computer tomography is the best radiologic evaluation. Differential diagnosis must be made with diverticulitis, acute appendicitis (8), Meckel´s diverticulum, omental infarction, mesenteric adenitis, ileitis and gynecological disease, although they present with malaise and constitutional syndrome (2,3,7,8).…”

“…As a self-limiting condition, patients are treated conservatively with oral analgesics and anti-inflammatory medication (1)(2)(3)(4)(5)(6)(7)(8). Antibiotics are not usually used.…”