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Primary epiploic appendagitis: Clinic and radiologic imaging findings

Year 2013, Volume: 40 Issue: 2, 264 - 268, 01.06.2013
https://doi.org/10.5798/diclemedj.0921.2013.02.0267

Abstract

Introduction: Primary epiploic appendagitis (PEA) is a rare and self-limiting disease that can mimicking acute apendicitis and diverticulitis because of the clinical symptoms. The present retrospective study was discussed to clinical and radiologic characteristics of PEA. Methods: We reviewed the clinical, laboratory and computed tomography (CT) findings of 10 patients with PEA between August 2010 and December 2012. Results: Ten patients (1 female and 9 males) were diagnosed with PEA. The average age was 37.1 (15-63) years. Abdominal pain was localized to the right (2 cases, 20%) or left (7 cases, 70%) lower quadrants and generalized (1 cases, 10%). All patients were afebrile. Only two patients showed leukocytosis. There were gastrointestinal symptoms such as nausea (3 patients) and vomiting (1patient). In all cases, a pericolic fatty mass with a hyper attenuated ring was observed on CT. All of the patients were treated symptomatic. Conlusion: In patients have atypical symptoms and laboratory values with abdominal pain (especially left lower abdominal pain), PEA should be considered in differential diagnosis. For correct diagnosis and avoid unnecessary surgery, CT must be used in diagnosis because imaging findings characteristic of the disease.

References

  • Horton KM, Corl FM, Fishman EK. CT evaluation of the colon: Inflammatory disease. Radiographics 2000;20:339- 418.
  • Vinson DR. Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review. J Emerg Med 1999;17:827-832.
  • Sajjad Z, Sajjad N, Friedman M, et al. Primary epiploic ap- pendagitis: an etiology of acute abdominal pain. Conn Med 2000;64:655-657.
  • Barbier C, Denny P, Pradoura JM, et al. Radiologic as- pects of infarction of the appendix epiploica. J Radiol 1998;79:1479-1485.
  • Rioux M, Langis P. Primary epiploic appendagitis: clinical, US, and CT finding in 14 cases. Radiology 1994;19:523- 526.
  • Blinder E, Ledbetter S, Rybicki F. Primary epiploic ap- pendagitis. Emerg Radiol 2002;9:231-233.
  • Sand M, Gelos M, Bechara F, et al. Epiploic appendagitis: clinical characteristics of an uncommon surgical diagnosis. BMC Surg 2007;1:7-11.
  • Almeida AT, Melao L, Viamonte B, et al. Epiploic Ap- pendagitis: An entity frequently unknown to clinicians- di- agnostic imaging, pitfalls, and look- alikes. Am J Roent- genol 2009;193:1243-1251.
  • Legome EL, Belton AL, Murray RE, et al. Epiploic ap- pendagitis: the emergency department presentation. J Emerg Med 2002;22:9-13.
  • Jalaguier A, Zins M, Rodallec M, et al. Accuracy of mul- tidetector computed tomography in differentiating primary epiploic appendagitis from left acute colonic diverticulitis associated with secondary epiploic appendagitis. Emerg Radiol 2010;17:51-56.
  • Rao PM, Wittenberg J, Lawrason JN. Primary epiploic ap- pendagitis: evolutionary changes in CT appearance. Radi- ology 1997;204:713-717.
  • Molla E, Ripolles T, Martinez MJ, et al. Primary epiploic appendagitis: US and CT findings. Eur Radiol 1998;8:435- 438.
  • Singh AK, Gervais DA, Hahn PF, et al. CT appearance of acute appendagitis. Am J Roentgenol 2004;183:1303-1307.
  • Sirvanci M, Balci NC, Karaman K, et al. Primary epi- ploic appendagitis: MRI findings. Magn Reson Imaging 2002;20:137-139.
  • Birjawi GA, Haddad MC, Zantout HM, et al. Primary epiploic appendagitis: a report of two cases. Clin Imaging 2000;24
  • Sandrasegaran K, Maglinte DD, Rajesh A, Akisik FM. Pri- mary epiploic appendagitis: CT diagnosis. Emerg Radiol 2004;11:9-14.
  • Pereira JM, Sirlin CB, Pinto PS, et al. Disproportionate fat stranding: a helpful CT sign in patients with acute abdomi- nal pain. Radiographics 2004;24:703-715.
  • Jeon YS, Lee JW, Cho SG. Is it from the mesentery or the omentum? MDCT features of various pathologic conditions in intraperitoneal fat planes. Surg Radiol Anat 2009;31:3- 11.
  • Bonnefoy S, Corberand D, Sinayoko L, et al. Epiploic appendagitis: report of a case. Gastroenterol Clin Biol 2008;32:1092-1094.

Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları

Year 2013, Volume: 40 Issue: 2, 264 - 268, 01.06.2013
https://doi.org/10.5798/diclemedj.0921.2013.02.0267

Abstract

Amaç: Primer epiploik apandisit (PEA), klinik semptomlarından dolayı akut apandisit ve divertikülit gibi hastalıkları taklit edebilen, nadir ve kendini sınırlayan bir hastalıktır. Bu retrospektif çalışmada primer epiploik apandisitin klinik ve radyolojik görüntüleme özellikleri tartışıldı. Yöntemler: Ağustos 2010 ve Aralık 2012 tarihleri arasında PEA tanısı alan 10 hastanın klinik, laboratuar ve bilgisayarlı tomografi (BT) bulguları gözden geçirildi. Bulgular: On hasta (1 kadın ve 9 erkek) PEA tanısı aldı. Yaş ortalaması 37,1 (15-63) yıl idi. İki hastada (%20) sağ alt kadran ağrısı, 7 hastada (%70) sol alt kadran ağrısı ve 1 hastada (%10) yaygın ağrı mevcuttu. Hiçbir hastada ateş yoktu. Sadece 2 hastada lökositoz görüldü. 3 hastada bulantı, 1 hastada kusma gibi gastrointestinal semptomlar vardı. Tüm hastalarda, BT\'de yüksek dansiteli periferik bir halka ile çevrili perikolonik yerleşimli yağlı kitle gözlendi. Tüm hastalarda semptomatik tedavi yapıldı. Sonuç: Atipik semptomları ve labaratuar bulguları olan akut karın ağrılı tüm hastalarda ( özellikle alt kadran ağrısı), PEA ayırıcı tanıda düşünülmelidir. Doğru tanı ve gereksiz cerrahi işlemleri önlemek için tanıda karakteristik görüntüleme bulguları olan BT kullanılmalıdır.

References

  • Horton KM, Corl FM, Fishman EK. CT evaluation of the colon: Inflammatory disease. Radiographics 2000;20:339- 418.
  • Vinson DR. Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review. J Emerg Med 1999;17:827-832.
  • Sajjad Z, Sajjad N, Friedman M, et al. Primary epiploic ap- pendagitis: an etiology of acute abdominal pain. Conn Med 2000;64:655-657.
  • Barbier C, Denny P, Pradoura JM, et al. Radiologic as- pects of infarction of the appendix epiploica. J Radiol 1998;79:1479-1485.
  • Rioux M, Langis P. Primary epiploic appendagitis: clinical, US, and CT finding in 14 cases. Radiology 1994;19:523- 526.
  • Blinder E, Ledbetter S, Rybicki F. Primary epiploic ap- pendagitis. Emerg Radiol 2002;9:231-233.
  • Sand M, Gelos M, Bechara F, et al. Epiploic appendagitis: clinical characteristics of an uncommon surgical diagnosis. BMC Surg 2007;1:7-11.
  • Almeida AT, Melao L, Viamonte B, et al. Epiploic Ap- pendagitis: An entity frequently unknown to clinicians- di- agnostic imaging, pitfalls, and look- alikes. Am J Roent- genol 2009;193:1243-1251.
  • Legome EL, Belton AL, Murray RE, et al. Epiploic ap- pendagitis: the emergency department presentation. J Emerg Med 2002;22:9-13.
  • Jalaguier A, Zins M, Rodallec M, et al. Accuracy of mul- tidetector computed tomography in differentiating primary epiploic appendagitis from left acute colonic diverticulitis associated with secondary epiploic appendagitis. Emerg Radiol 2010;17:51-56.
  • Rao PM, Wittenberg J, Lawrason JN. Primary epiploic ap- pendagitis: evolutionary changes in CT appearance. Radi- ology 1997;204:713-717.
  • Molla E, Ripolles T, Martinez MJ, et al. Primary epiploic appendagitis: US and CT findings. Eur Radiol 1998;8:435- 438.
  • Singh AK, Gervais DA, Hahn PF, et al. CT appearance of acute appendagitis. Am J Roentgenol 2004;183:1303-1307.
  • Sirvanci M, Balci NC, Karaman K, et al. Primary epi- ploic appendagitis: MRI findings. Magn Reson Imaging 2002;20:137-139.
  • Birjawi GA, Haddad MC, Zantout HM, et al. Primary epiploic appendagitis: a report of two cases. Clin Imaging 2000;24
  • Sandrasegaran K, Maglinte DD, Rajesh A, Akisik FM. Pri- mary epiploic appendagitis: CT diagnosis. Emerg Radiol 2004;11:9-14.
  • Pereira JM, Sirlin CB, Pinto PS, et al. Disproportionate fat stranding: a helpful CT sign in patients with acute abdomi- nal pain. Radiographics 2004;24:703-715.
  • Jeon YS, Lee JW, Cho SG. Is it from the mesentery or the omentum? MDCT features of various pathologic conditions in intraperitoneal fat planes. Surg Radiol Anat 2009;31:3- 11.
  • Bonnefoy S, Corberand D, Sinayoko L, et al. Epiploic appendagitis: report of a case. Gastroenterol Clin Biol 2008;32:1092-1094.
There are 19 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Mustafa Koplay This is me

Seda Ozbek This is me

Mesut Sivri This is me

Hüsnü Alptekin This is me

Hasan Erdoğan This is me

Alaaddin Nayman This is me

Publication Date June 1, 2013
Submission Date March 2, 2015
Published in Issue Year 2013 Volume: 40 Issue: 2

Cite

APA Koplay, M., Ozbek, S., Sivri, M., Alptekin, H., et al. (2013). Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları. Dicle Tıp Dergisi, 40(2), 264-268. https://doi.org/10.5798/diclemedj.0921.2013.02.0267
AMA Koplay M, Ozbek S, Sivri M, Alptekin H, Erdoğan H, Nayman A. Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları. diclemedj. June 2013;40(2):264-268. doi:10.5798/diclemedj.0921.2013.02.0267
Chicago Koplay, Mustafa, Seda Ozbek, Mesut Sivri, Hüsnü Alptekin, Hasan Erdoğan, and Alaaddin Nayman. “Primer Epiploik Apandisit: Klinik Ve Radyolojik görüntüleme Bulguları”. Dicle Tıp Dergisi 40, no. 2 (June 2013): 264-68. https://doi.org/10.5798/diclemedj.0921.2013.02.0267.
EndNote Koplay M, Ozbek S, Sivri M, Alptekin H, Erdoğan H, Nayman A (June 1, 2013) Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları. Dicle Tıp Dergisi 40 2 264–268.
IEEE M. Koplay, S. Ozbek, M. Sivri, H. Alptekin, H. Erdoğan, and A. Nayman, “Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları”, diclemedj, vol. 40, no. 2, pp. 264–268, 2013, doi: 10.5798/diclemedj.0921.2013.02.0267.
ISNAD Koplay, Mustafa et al. “Primer Epiploik Apandisit: Klinik Ve Radyolojik görüntüleme Bulguları”. Dicle Tıp Dergisi 40/2 (June 2013), 264-268. https://doi.org/10.5798/diclemedj.0921.2013.02.0267.
JAMA Koplay M, Ozbek S, Sivri M, Alptekin H, Erdoğan H, Nayman A. Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları. diclemedj. 2013;40:264–268.
MLA Koplay, Mustafa et al. “Primer Epiploik Apandisit: Klinik Ve Radyolojik görüntüleme Bulguları”. Dicle Tıp Dergisi, vol. 40, no. 2, 2013, pp. 264-8, doi:10.5798/diclemedj.0921.2013.02.0267.
Vancouver Koplay M, Ozbek S, Sivri M, Alptekin H, Erdoğan H, Nayman A. Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları. diclemedj. 2013;40(2):264-8.