• Ryohei Uehara, Hajime Isomoto, Naoyuki Yamaguchi, Ken Ohnita, Fumihiko Fujita, Tatsuki Ichikawa, Fuminao Takeshima, Tetsuji Yamaguchi, Masataka Uetani, and Kazuhiko Nakao.
• Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
• Med. Sci. Monit. 2011 Oct 1;17(10):CS113-5.

BackgroundEpiploic appendagitis is an ischemic infarction of an epiploic appendage caused by torsion or spontaneous thrombosis of the central draining vein. Epiploic appendagitis is self-limited without surgery, and it is imperative for clinicians to be familiar with this entity.Case ReportA healthy 27-year-old man was admitted due to acute right lower quadrant abdominal pain. Physical examination showed focal abdominal tenderness with slight rebound tenderness. Laboratory tests showed leukocytosis and an increased serum C-reactive protein level. Computed tomography (CT) showed a fatty ovoid pericolonic mass measuring 12 mm in diameter, with a circumferential hyperdense ring that abutted on the ascending colon and was surrounded by ill-defined fat stranding with a hyperdense ring. These findings were diagnostic of primary epiploic appendagitis. The patient was given high-dose antibiotics due to the secondary inflammation involving the parietal peritoneum.ConclusionsEpiploic appendagitis presents with an abrupt onset of focal abdominal pain and tenderness without significant guarding or rigidity; it is an uncommon and difficult diagnosis. With awareness of this condition, however, evaluation by CT can provide an accurate diagnosis of epiploic appendagitis, distinguishing it from conditions with clinically overlapping manifestations.

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