Primary Epiploic Appendagitis of the Appendix Vermiformis

Title:Primary Epiploic Appendagitis of the Appendix Vermiformis

Volume: 19

Author(s): Servet Kahveci*, Soubhi Zitouni, Abdul Razak Abubakar, Turkan Ikizceli, Mehmet Ozturk and Yusuf Aksu*

Affiliation:

• Department of Radiology, Primer Healthcare Centre, Qatar University, Doha, Qatar

• Department of Radiology, Nevşehir State Hospital, Nevşehir, Turkey

Keywords: Abdominal pain, Epiploic appendagitis, Misdiagnosed disease, PEA, CT, appendix vermiformis.

Abstract:

Introduction: Primary epiploic appendagitis, a relatively rare and self-limiting disease, often clinically mimics conditions of the acute abdomen such as acute appendicitis and acute diverticulitis. It is important to make accurate diagnoses because its treatment is conservative. Ultrasonography and computed tomographic studies enable a reliable diagnosis to prevent unnecessary invasive procedures. Herein, we report a case of primary epiploic appendagitis of the appendix vermiformis with clinical, laboratory and CT findings to improve awareness of this condition.

Case Presentation: A 29-year-old female presented with acute abdominal pain in the right lower quadrant. Her medical history was not significant for surgery. She had no nausea, vomiting, diarrhea or fever. On physical examination, she had right lower quadrant tenderness with mild defense and rebound upon palpation. The leukocyte count (6300 mm-3) and other laboratory parameters, including urine tests, were unremarkable. With these findings, the provisional diagnosis of acute appendicitis was made, and a CT examination (Mx 8000 IDT 16, Philips, USA) was done upon the request of the referring physicians. The abdominal CT showed normal appendix vermiformis. However, a fat density lesion surrounding a hyperdense rim was seen adjacent to the appendix vermiformis. The diagnosis of PEA was thus established based on the characteristic radiologic findings. The patient was managed conservative treatment with pain medication as an outpatient. After a one-week follow-up, the patient was observed to be symptom-free and concluded to have recovered fully from their physician.

Conclusion: To conclude, PEA needs to be considered by emergency clinicians and radiologists in the differential diagnosis of acute abdominal pain. With this in mind, it becomes easier for a substantive diagnosis to be made by ultrasound alone or combined with CT to prevent unnecessary surgical interventions, antibiotherapy and hospitalization.

Cite this article as:

Kahveci Servet*, Zitouni Soubhi, Abubakar Razak Abdul, Ikizceli Turkan, Ozturk Mehmet and Aksu Yusuf*, Primary Epiploic Appendagitis of the Appendix Vermiformis, Current Medical Imaging 2023; 19 (10) : e160822207518 . https://dx.doi.org/10.2174/1573405618666220816103122

DOI https://dx.doi.org/10.2174/1573405618666220816103122	Print ISSN 1573-4056
Publisher Name Bentham Science Publisher	Online ISSN 1875-6603