Cecal Epiploic Appendagitis: A Diagnostic and Therapeutic Dilemma

2007 ◽  
Vol 73 (8) ◽  
pp. 828-830 ◽  
Author(s):  
Vijaykumar G. Patel ◽  
Arundathi Rao ◽  
Reginald Williams ◽  
Radha Srinivasan ◽  
James K. Fortson ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Radiographic Findings ◽  
Epiploic Appendagitis ◽  
Abdominal Symptoms ◽  
Abdominal Ct Scan ◽  
Limiting Condition

Acute epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. Though a benign and often self-limiting condition, EA's ability to mimic other disease processes makes it an important consideration in patients presenting with acute abdominal symptoms. Careful evaluation of abdominal CT scan findings is crucial in the accurate diagnosis of epiploic appendagitis, thus avoiding unnecessary surgical intervention. We report a case of a 29-year-old male presenting with a two day history of generalized abdominal pain. Physical exam revealed a diffusely tender abdomen with hypoactive bowel sounds. The patient had a leukocytosis of 18,000 and abdominal CT scan revealed right lower quadrant inflammatory changes suggestive of acute appendicitis. Laparoscopic exploration revealed an inflamed gangrenous structure adjacent to the ileocecal junction. Pathologic evaluation revealed tissue consistent with epiploic appendagitis. Retrospective review of the CT scan revealed a normal appearing appendiceal structure superolateral to the area of inflammation. The patient recovered uneventfully with resolving leukocytosis. We present a case of cecal epiploic appendagitis mimicking acute appendicitis and review the current literature on radiographic findings, diagnosis, and treatment of this often misdiagnosed condition. General surgeons should be aware of this self-limiting condition and consider this in the differential diagnosis.

scholarly journals Omental infarction following colonoscopy

2015 ◽  
Vol 06 (02) ◽  
pp. 073-075
Author(s):  
Antonio Gangemi ◽  
Aqsa Durrani ◽  
Brian R. Boulay
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdominal Pain ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Omental Infarction ◽  
Abdominal Ct Scan ◽  
The Right ◽  
Inflammatory Changes ◽  
Right Lower Quadrant

AbstractDiagnosis of omental infarction, while rare, has become increasingly common likely due to improvements in diagnostic imaging. Reported incidence of omental infarction varies; however, omental infarction has not yet been described in association with colonoscopy. Common complications of colonoscopy include complications of sedation, complications of bowel preparation, and bleeding following polypectomy, and rarely, perforation or infection. We describe herein a case of a 63-year-old female who developed acute right lower quadrant abdominal pain following a colonoscopy. Abdominal computed tomography (CT) scan revealed omental infarction in the right lower quadrant. Conservative management was employed, and the patient was observed for resolution of symptoms. Repeat abdominal CT scan 2 weeks following initial presentation showed resolution of inflammatory changes associated with omental infarction. The patient also improved clinically. Omental infarction should be considered in patients presenting with acute abdominal pain following colonoscopy.

964 Prevalence of Opioid Analgesic Use Among Patients Presenting to Emergency Department With Abdominal Pain That Is Investigated With Emergent Abdominal CT Scan

2016 ◽  
Vol 150 (4) ◽  
pp. S192-S193 ◽  
Author(s):  
Disha Khemani ◽  
Ana Roldan ◽  
Alfred D. Nelson ◽  
Seon-Young Park ◽  
Andres Acosta ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Opioid Analgesic ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Analgesic Use

scholarly journals Acute Appendicitis in a Man Undergoing Therapy for Mantle Cell Lymphoma

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Michael Linden ◽  
Ajay Gopal ◽  
Kerstin Edlefsen
Keyword(s):  
Acute Appendicitis ◽  
Mantle Cell Lymphoma ◽  
Cell Lymphoma ◽  
Open Appendectomy ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Mantle Cell ◽  
Abdominal Ct Scan ◽  
Right Lower Quadrant ◽  
Lymphoid Aggregates

A 71-year-old man was diagnosed with an aggressive mantle cell lymphoma and was started on six cycles of R-CHOP chemotherapy. Approximately two weeks after starting his first cycle of chemotherapy, he complained of severe right lower quadrant abdominal pain, and an abdominal CT scan demonstrated an enlarged appendix with evidence of contained perforation. The man underwent open appendectomy for acute appendicitis and recovered. The appendectomy specimen was submitted for routine pathological analysis. There was histologic evidence of perforation in association with an inflammatory infiltrate with fibrin adhered to the serosal surface; scattered small lymphoid aggregates were present on the mucosal surface. Although the lymphoid aggregates in the submucosa and lamina propria were rather unremarkable by routine histologic examination, immunohistochemistry revealed the lymphocytes to be predominantly Cyclin D1-overexpressing B cells. To our knowledge, this is the first reported case of acute appendicitis in association with appendiceal involvement by mantle cell lymphoma.

scholarly journals A Case of Unresolved and Worsening Retroperitoneal Abscess

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Raghav Bansal ◽  
Mohamed Barakat ◽  
Soohwan Chun ◽  
Sonam Rosberger ◽  
Joel Baum ◽  
...  
Keyword(s):  
Ct Scan ◽  
Rare Complication ◽  
Duodenal Bulb ◽  
Rare Condition ◽  
Distal Portion ◽  
Retroperitoneal Abscess ◽  
Gallstone Pancreatitis ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Abdominal Ct Scan

Retroperitoneal abscess is a rare condition which is difficult to diagnose and treat because of its insidious onset. Herein, we present a case of retroperitoneal abscess secondary to a perforation that occurred during an ERCP. A 54-year-old female patient was admitted to an outside hospital with gallstone pancreatitis and underwent ERCP with sphincterotomy followed by laparoscopic cholecystectomy. An abdominal CT scan was performed at the outside hospital 10 days later for worsening abdominal pain which showed multiple loculated pockets in the right upper and lower quadrant. Her condition improved after IV antibiotics and percutaneous drainage. Her symptoms recurred a month later and she presented to our hospital. Repeat abdominal CT scan at our hospital revealed recurrence of her abscesses. Multiple drains were placed and the abscess cavity was washed out without much improvement. EGD revealed a small mucosal defect in the distal portion of the duodenal bulb which was closed successfully using an over-the-scope clip. Repeat CT scan after 8 weeks from the endoscopic closure showed near complete resolution of the abscess. ERCP-associated perforation is a rare complication and can be challenging to diagnose and treat; prompt recognition is mandatory for favorable prognosis. Our patient was managed successfully via nonsurgical approach.

What is the Diagnostic Utility of an Abdominal CT Scan in the Hospitalized Medical Patient With Nonspecific Abdominal Pain?

2011 ◽  
Vol 140 (5) ◽  
pp. S-565
Author(s):  
Imran Sheikh ◽  
Maya Merheb ◽  
Amy Soloman ◽  
Wen Zhang ◽  
Catherine Curley ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Medical Patient ◽  
Diagnostic Utility ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

Abdominal CT Scanning in Reproductive-Age Women with Right Lower Quadrant Abdominal Pain: Does Its Use Reduce Negative Appendectomy Rates and Healthcare Costs?

2007 ◽  
Vol 73 (6) ◽  
pp. 580-584 ◽  
Author(s):  
Bryan C. Morse ◽  
Richard H. Roettger ◽  
Corey A. Kalbaugh ◽  
Dawn W. Blackhurst ◽  
William B. Hines
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ct Scanning ◽  
Reproductive Age ◽  
Negative Appendectomy ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Quadrant Abdominal Pain ◽  
Reproductive Age Women ◽  
Right Lower Quadrant

Although acute appendicitis is the most frequent cause of the acute abdomen in the United States, its accurate diagnosis in reproductive-age women remains difficult. Problems in making the diagnosis are evidenced by negative appendectomy rates in this group of 20 per cent to 45 per cent. Abdominal CT scanning has been used in diagnosing acute appendicitis, but its reliability and usefulness remains controversial. There is concern that the use of CT scanning to make this diagnosis leads to increased and unwarranted healthcare charges and costs. The purpose of our study is to determine if abdominal CT scanning is an effective test in making the diagnosis of acute appendicitis in reproductive-age women (age, 16–49 years) with right lower quadrant abdominal pain and to determine if its use is cost-effective. From January 2003 to December 2006, 439 patients were identified from our academic surgical database and confirmed by chart review as undergoing an appendectomy with a pre- or postoperative diagnosis of acute appendicitis. Data, including age, presence and results of preoperative abdominal CT scans, operative findings, and pathology reports were reviewed. Comparison of patients receiving a preoperative CT scan with those who did not was performed using chi-squared analysis. In the subgroup of reproductive-age women, there was a significant difference in negative appendectomy rates of 17 per cent in the group that received abdominal CT scans versus 42 per cent in the group that did not ( P < 0.038). After accounting for the patient and insurance company costs, abdominal CT scan savings averaged $1412 per patient. Abdominal CT scanning is a reliable, useful, and cost-effective test for evaluating right lower quadrant abdominal pain and making the diagnosis of acute appendicitis in reproductive-age women.

scholarly journals Epiploic Appendagitis Mimicking Recurrent Diverticulitis

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
R. Plummer ◽  
Y. Sekigami ◽  
Lilian Chen ◽  
James Yoo
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Sigmoid Colon ◽  
Lower Quadrant ◽  
Epiploic Appendagitis ◽  
Left Lower Quadrant ◽  
Quadrant Abdominal Pain ◽  
Recurrent Diverticulitis ◽  
Intravenous Antibiotics ◽  
History Of

Here, we report a case in which a patient with an extensive history of diverticulitis of the sigmoid colon presented with left lower quadrant abdominal pain similar to her previous episodes of diverticulitis. An initial diagnosis of diverticulitis was made based on her history and exam, intravenous antibiotics were given, and an elective surgical resection was considered. However, a subsequent CT scan revealed epiploic appendagitis with no evidence of diverticulitis. Though uncommon, in patients with a history of recurrent diverticulitis, alternative causes of left lower quadrant abdominal pain such as epiploic appendagitis should be considered as this may alter future treatment decisions.

TRAUMA GINJAL

2020 ◽  
Vol 4 (1) ◽  
pp. 52-57
Author(s):  
Noflih Sulistia ◽  
Bambang Soeprijanto ◽  
Indrastuti Normahayu ◽  
Lenny Violetta
Keyword(s):  
Ct Scan ◽  
Pediatric Patients ◽  
Radiological Examination ◽  
Renal Trauma ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

Renal trauma in children is more common than in adults. Clinically in pediatric patients with renal trauma do not always describe the degreeof trauma. Radiological examination, especially abdominal CT-scan with contrast, can help evaluate the damage to the kidneys so that it candetermine the degree of trauma.

Study on the Radiation Dose of Abdominal CT Scan Using Dual Energy

2018 ◽  
Vol 20 (2) ◽  
pp. 123-132
Author(s):  
Dae-hyun Park ◽  
Young-Kyoon Kim ◽  
Jong-Ho Ahn ◽  
Kwang-Hyun Chang ◽  
Yoon-Chul Nam ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ct Scan ◽  
Dual Energy ◽  
Abdominal Ct ◽  
Abdominal Ct Scan

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

Sign in / Sign up

Export Citation Format

Share Document