Epiploic appendagitis mimicking acute cholecystitis

Lien, Wan‐Ching; Lai, Tsung‐Ching; Lin, Geng-Shiau; Wang, Hsiu-Po; Chen, Wen‐Jone; Cheng, Tsu‐Yao

doi:10.1016/j.ajem.2004.07.018

Cited by 15 publications

(10 citation statements)

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“…La douleur peut être sourde ou vive ou ressembler à une colique [10]. Lorsque l'AEP survient sur le côlon transverse ou aux angles coliques, elle peut provoquer des symptômes tels qu'une toux ou une inhibition de la respiration profonde à la palpation [11]. Une diarrhée est observée dans 25 % des cas, alors que la fièvre (> 38,5°C) est présente chez moins de 15 % des malades [2].…”

Section: Discussionunclassified

“…En effet, une CRP et un nombre de leucocytes normaux sont plus fréquemment observés dans l'AEP que dans la sigmoïdite diverticulaire (80 % versus 55-75 %) [2]. De façon plus exceptionnelle, la torsion peut intéresser les franges du côlon droit ou du côlon transverse et simuler une appendicite ou une cholécystite [6,11]. Pour la plupart des patients, le diagnostic n'était jadis confirmé que lors d'une laparotomie (ou laparoscopie) exploratrice [4,5,12].…”

Section: Discussionunclassified

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Appendagite épiploïque primitive: un diagnostic non chirurgical souvent méconnu

Kianmanesh¹,

Abdullah²,

Scaringi³

et al. 2007

La Presse Médicale

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Section: Discussionunclassified

Appendagite épiploïque primitive: un diagnostic non chirurgical souvent méconnu

Kianmanesh¹,

Abdullah²,

Scaringi³

et al. 2007

La Presse Médicale

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“…Torsion of the epiploic appendages is rare, but can result in ischemia presenting as an acute clinical condition which can mimic diverticulitis, appendicitis, or other more serious causes of acute abdominal pain [4]. Besides torsion, which is most likely the main pathophysiological mechanism, spontaneous venous thrombosis of an appendageal draining vein is another uncommon cause of primary epiploic appendagitis [5,6].…”

Section: Introductionmentioning

confidence: 99%

Epiploic appendagitis – clinical characteristics of an uncommon surgical diagnosis

et al. 2007

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BackgroundEpiploic appendagitis (EA) is a rare cause of focal abdominal pain in otherwise healthy patients with mild or absent secondary signs of abdominal pathology. It can mimick diverticulitis or appendicitis on clinical exam. The diagnosis of EA is very infrequent, due in part to low or absent awareness among general surgeons. The objective of this work was to review the authors' experience and describe the clinical presentation of EA.MethodsAll patients diagnosed with EA between January 2004 and December 2006 at an urban surgical emergency room were retrospectively reviewed by two authors in order to share the authors' experience with this rare diagnosis. The operations were performed by two surgeons. Pathological examinations of specimens were performed by a single pathologist. A review of clinical presentation is additionally undertaken.ResultsTen patients (3 females and 7 males, average age: 44.6 years, range: 27–76 years) were diagnosed with symptomatic EA. Abdominal pain was the leading symptom, the pain being localized in the left (8 patients, 80 %) and right (2 patients, 20%) lower quadrant. All patients were afebrile, and with the exception of one patient, nausea, vomiting, and diarrhea were not present. CRP was slightly increased (mean: 1.2 mg/DL) in three patients (33%). Computed tomography findings specific for EA were present in five patients. Treatment was laparoscopic excision (n = 8), excision via conventional laparotomy (n = 1) and conservative therapy (n = 1).ConclusionIn patients with localized, sharp, acute abdominal pain not associated with other symptoms such as nausea, vomiting, fever or atypical laboratory values, the diagnosis of EA should be considered. Although infrequent up to date, with the increase of primary abdominal CT scans and ultrasound EA may well be diagnosed more frequently in the future.

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“…This can be explained by the fact that the most common site of appendagitis is the sigmoid colon, and thus it is usually mistakenly diagnosed as diverticulitis. 3 This condition, however, can also mimic acute appendicitis, 1 , 3 , 4 cholecystitis 5 and virtually any other cause of acute abdomen. Laboratory examination is typically normal, and only a few patients present with leucocytosis.…”

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confidence: 99%