scholarly journals CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Dario Giambelluca ◽  
Roberto Cannella ◽  
Giovanni Caruana ◽  
Leonardo Salvaggio ◽  
Emanuele Grassedonio ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Acute Diverticulitis ◽  
Abdominal Cavity ◽  
Imaging Features ◽  
Imaging Findings ◽  
Hernia Sac ◽  
Epiploic Appendagitis ◽  
High Attenuation ◽  
Epiploic Appendage

AbstractEpiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation surrounded by a thin hyperdense rim on CT (“hyperattenuating ring sign”) abutting anteriorly the large bowel, usually associated with inflammation of the adjacent mesentery. A central high-attenuation focus within the fatty lesion (“central dot sign”) can sometimes be observed and is indicative of a central thrombosed vein within the inflamed epiploic appendage. Rarely, epiploic appendagitis may be located within a hernia sac or attached to the vermiform appendix. Chronically infarcted epiploic appendage may detach, appearing as an intraperitoneal loose calcified body in the abdominal cavity. In this review, we aim to provide an overview of the clinical presentation and key imaging features that may help the radiologist to make an accurate diagnosis and guide the clinical management of those patients.

scholarly journals Acute Epiploic Appendagitis: A Nonsurgical Abdominal Pain

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Marco Di Serafino ◽  
Francesca Iacobellis ◽  
Piero Trovato ◽  
Ciro Stavolo ◽  
Antonio Brillantino ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Imaging ◽  
Acute Abdominal Pain ◽  
Lower Abdominal Pain ◽  
Imaging Features ◽  
Imaging Findings ◽  
Epiploic Appendagitis ◽  
Surgical Interventions ◽  
Diagnosis By Exclusion ◽  
Epiploic Appendices

Epiploic appendagitis is a relatively rare disease characterized by an inflammation of fat-filled serosal outpouchings of the large intestine, called epiploic appendices. Diagnosis of epiploic appendagitis is made challenging by the lack of pathognomonic clinical features and should therefore be considered as a potential diagnosis by exclusion first of all with appendicitis or diverticulitis which are the most important causes of lower abdominal pain. Currently, with the increasing use of ultrasound and computed tomography in the evaluation of acute abdominal pain, epiploic appendagitis can be diagnosed by characteristic diagnostic imaging features. We present a case of epiploic appendagitis with objective of increasing knowledge of this disease and its diagnostic imaging findings, in order to reduce harmful and unnecessary surgical interventions.

scholarly journals Epiploic Appendagitis: An Often Misdiagnosed Cause of Acute Abdomen

2019 ◽  
Vol 13 (3) ◽  
pp. 364-368
Author(s):  
Vishnu Charan Suresh Kumar ◽  
Kishore Kumar Mani ◽  
Hisham Alwakkaa ◽  
James Shina
Keyword(s):  
Abdominal Pain ◽  
Bowel Wall ◽  
Acute Diverticulitis ◽  
Lower Abdominal Pain ◽  
Wall Thickening ◽  
Antibiotic Administration ◽  
Epiploic Appendagitis ◽  
High Attenuation ◽  
History Of ◽  
Bowel Wall Thickening

Epiploic appendages are peritoneal structures that arise from the outer serosal surface of the bowel wall towards the peritoneal pouch. They are filled with adipose tissue and contain a vascular stalk. Epiploic appendagitis is a rare cause of acute lower abdominal pain. It most commonly results from torsion and inflammation of the epiploic appendages, and its clinical features mimic acute diverticulitis or acute appendicitis resulting in being often misdiagnosed as diverticulitis or appendicitis. This frequently leads to unnecessary hospitalization, antibiotic administration, and unwarranted surgeries. Epiploic appendagitis is usually diagnosed with CT imaging, and the classic CT findings include: (i) fat-density ovoid lesion (hyperattenuating ring sign), (ii) mild bowel wall thickening, and (iii) a central high-attenuation focus within the fatty lesion (central dot sign). It is treated conservatively, and symptoms typically resolve in a few days. Therefore, epiploic appendagitis should be considered as one of the differential diagnosis for acute lower abdominal pain and prompt diagnosis of epiploic appendagitis can avoid unnecessary hospitalization and surgical intervention. In this case report, we discuss a 72-year-old woman who presented with a 2-day history of acute left lower abdominal pain.

scholarly journals A Case Series on Epiploic Appendagitis: An Underdog in Acute Abdomen

2021 ◽  
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Pradeep Joshua Christopher ◽  
Sudha Kanthasamy ◽  
Jeyakumar Sundaraj
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Case Series ◽  
Lower Abdominal Pain ◽  
Surgical Excision ◽  
Epiploic Appendagitis ◽  
Common Causes ◽  
Epiploic Appendage

Epiploic appendagitis is an uncommon yet a significant surgical diagnosis that every surgeon should be aware. It occurs due to the torsion of the epiploic appendage which gives rise to acute abdominal pain that can mimic other common causes of acute abdominal pain like appendicitis or cholecystitis. The treatment of epiploic appendagitis depend on clinical presentation, severity and it varies from conservative management to surgical excision. This case series is about eight patients presented with complaints of lower abdominal pain. After clinical examination they were initially diagnosed to have appendicitis or diverticulitis. The Computed Tomography (CT) -based diagnoses were appendicitis, omental infarct, diverticulitis or epiploic appendagitis. All of them were subjected to diagnostic laparoscopy and found to have an inflammed epiploic appendage which was excised laparoscopically.

scholarly journals An Uncommon Cause of Acute Abdominal Pain: Primary Epiploic Appendagitis in the Emergency Setting

2017 ◽  
Vol 31 (1&2) ◽  
pp. 17
Author(s):  
Scott D. Casey ◽  
Joseph DiVito Jr. ◽  
Jason B. Lupow ◽  
Reshma Gulani
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Emergency Physician ◽  
Acute Abdominal Pain ◽  
Acute Diverticulitis ◽  
Emergency Setting ◽  
Imaging Studies ◽  
Epiploic Appendagitis ◽  
Medical Interventions

In the emergency setting, the diagnosis of benign causes of acute abdominal pain can prevent unnecessary medical interventions. To illustrate this point, we report the case of a 28-year-old man who presented to the emer- gency department with symptoms suggestive of acute diverticulitis. Abdominal computed tomography (CT) established, instead, a diagnosis of primary epiploic appendagitis (PEA), which was managed expectantly. The patient’s symptoms resolved within one week of hospital discharge and he remained free of pain at a five-month phone follow-up. Increased awareness of PEA and its self-limited course can help the emergency physician avoid unnecessary imaging studies and expectantly manage this cause of acute abdominal pain. 

scholarly journals Parasitic diseases as a cause of acute abdominal pain: imaging findings

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Emre Ünal ◽  
Sevtap Arslan ◽  
Mehmet Ruhi Onur ◽  
Erhan Akpinar
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Parasitic Diseases ◽  
Imaging Findings

scholarly journals Midgut malrotation with volvulus - a case report

2013 ◽  
Vol 02 (02) ◽  
pp. 082-085
Author(s):  
Pradipta Ray Choudhury ◽  
Prasant Sarda ◽  
Shobhit Singh ◽  
Prabahita Baruah ◽  
K. L. Talukdar
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Recurrent Abdominal Pain ◽  
Midgut Malrotation ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

AbstractMidgut malrotation is a rare anatomic anomaly that complicates the diagnosis and management of acute abdominal pain. It is a congenital anomaly that arises from incomplete rotation or abnormal position of the midgut during embryonic development. A two years old boy was brought with recurrent abdominal pain and vomiting. On ultrasonography, the intestinal malrotation was suspected and thus contrast enhanced computed tomography (CECT) was done. On CECT, abnormal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV), colon on the left side of the abdominal cavity, 'Whirlpool sign' etc., were found. All findings were suggestive of midgut malrotation with volvulus. Detection of uncomplicated malrotation should not be trivialized because such patients might experience a future complication.

scholarly journals Hydatid cysts of the liver rupture into the peritoneal cavity: Fifteen cases and review of the literature

2021 ◽  
Author(s):  
Atef MEJRI ◽  
Khaoula ARFAOUI ◽  
Sarra SAAD ◽  
Jasser RCHIDI ◽  
Ahmed OMRI ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Peritoneal Cavity ◽  
Cyst Wall ◽  
Anaphylactic Shock ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Surgical Care ◽  
Liver Hydatid Cyst ◽  
The Mean

Abstract BackgroundHydatid cyst is an infectious disease caused mainly by E. Granulosus, which is generally considered benign, however, the rupture of the hepatic Hydatid Cyst to the abdominal cavity is a life-threatening incident that requires urgent and multidisciplinary management (emergency physician, radiologists, aneasthetists and surgeons). This study aims to describe the various clinical and paraclinical features of ruptured liver hydatid cyst in the peritoneal cavity, and to detail the appropriate treatment.Materials and MethodsFifteen cases of ruptured liver hydatid cyst into the abdominal cavity that underwent urgent surgery were collected over a period of eight years. Results There were nine men and six women. The average age was 38 years. Two patients were admitted with abdominal trauma. All patients presented with acute abdominal pain. Only one patient had anaphylactic shock. Abdominal ultrasound showed discontinuous cyst wall and intraperitoneal fluid in 100% of cases. Abdominal computed tomography (CT) showed discontinuous cyst wall with intraperitoneal fluid in 100% of cases. Intraoperatively, the intraperitoneal fluid was clear in thirteen cases and purulent in two. All patients underwent unroofing procedure associated with intra-operative peritoneal lavage and external drainage. The mean hospital stay was 6.11 days and the mean follow-up was 19 months. No case of recurrence was reported among the patients.ConclusionRupture of a hydatid cyst in the abdominal cavity should be considered as a differential diagnosis in every case of an acute abdominal pain, especially in endemic areas and in presence of an allergic reaction or signs of anaphylactic shock. Combined medical and surgical care starting in the emergency room is the only guarantee of a good outcome.

scholarly journals ACUTE GASTRIC VOLVULUS WITH PERFORATION

2018 ◽  
Vol 25 (3) ◽  
pp. 173-177 ◽  
Author(s):  
I. H. SHIDAKOV ◽  
B. M. KALNIYAZOV ◽  
A. A. KARAEV
Keyword(s):  
Abdominal Pain ◽  
Clinical Case ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Gastric Lavage ◽  
Gastric Volvulus ◽  
Diagnostic Errors ◽  
Underlying Disease ◽  
Acute Gastric Volvulus ◽  
Upper Gastrointestinal

Aim. To demonstrate a clinical case of acute gastric volvulus and to give a brief literary review of the disease. Materials and methods. A 12-year-old child who has applied for acute abdominal pain, repeated vomiting, with typical signs of obstruction of the upper gastrointestinal tract.Results. After the clinical and instrumental examination, the child was urgently operated. With laparotomy, the patient was diagnosed with acute secondary gastric volvulus with necrosis and perforation, against the background of a true left-sided diaphragmatic hernia, severe pancreatic lesions. The patient had a suturing of the stomach defect, diaphragm plastic, thorough sanitation and drainage of the abdominal cavity. The postoperative period was very difficult, due to complications of the underlying disease. As a result of the treatment, the patient was discharged in satisfactory condition.Conclusion. The clinical case confirms the severity of this nosology, accompanied by serious consequences. In our case, the patient recovered, but diagnostic errors and developing complications in acute gastric lavage often lead to death.

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