Primary Epiploic Appendagitis: Not Rare But Rarely Diagnosed Pathology

Title:Primary Epiploic Appendagitis: Not Rare But Rarely Diagnosed Pathology

Volume: 19

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

Affiliation:

• Department of Radiology, Qatar University Health Center, Doha, Qatar

Abstract:

Objective: The aim of this study is to determine the clinical and laboratory parameters which may be suggestive of or even pathognomonic for primary epiploic appendagitis (PEA) and to discuss the diagnostic efficacy of ultrasound (US) compared to computed tomography (CT) in patients with PEA.

Materials and Methods: For this retrospective study, 92 patients diagnosed with PEA using US, CT or both modalities were included. All patient symptoms, clinical findings and laboratory parameters were reviewed. The CT and US images of the PEA were evaluated for lesion size and location, the relationship of the lesion to the colon and the distance of the lesion to the skin.

Results: There were 16 female and 76 male patients in the study group. The mean age was 35 years (range: 38–79 years). Well-localized abdominal pain was the primary symptom in all patients. The mean leukocyte count was 7857±1326 mm^-3. The most frequent localization of PEA was sigmoiddescending colon junction (79/92). In patients who were examined by both US and CT, the size of the fatty central core was between 15-48 mm (mean:28.10 mm) and 9-22 mm (mean:15.07 mm) in its long-axis and short-axis diameter, respectively on US, whilst that by CT was between 15-46 mm (mean:26.88 mm) and 9-21 mm (mean:14.40 mm) in its long-axis and short-axis diameter, respectively. In patients who were examined by both US and CT, the mean distance of the lesions to the skin was 20.80 mm and 33.97 mm, respectively. All patients were treated conservatively with complete resolution of symptoms within a week of presentation.

Conclusion: PEA is an unrare self-limiting condition that should be considered in the differential diagnosis of acute abdomen. To support clinicians and radiologists regarding PEA and its clinical, laboratory and radiological findings, targeted sonographic examination - which is radiation and contrast agent-free - could be highly sufficient for the diagnosis of PEA and may prevent unnecessary further imaging and mistreatment.

Cite this article as:

Kahveci Servet*, Zitouni Soubhi, Abubakar Razak Abdul, İkizceli Turkan, Ozturk Mehmet, Aktürk Adem and Aksu Yusuf, Primary Epiploic Appendagitis: Not Rare But Rarely Diagnosed Pathology, Current Medical Imaging 2023; 19 (11) : e130123212723 . https://dx.doi.org/10.2174/1573405619666230113122949

DOI https://dx.doi.org/10.2174/1573405619666230113122949	Print ISSN 1573-4056
Publisher Name Bentham Science Publisher	Online ISSN 1875-6603