A Rare Pathology Mimicing Acute Appendicitis; Epiploic Appendagitis

Abstract

Aim: Primary epiploic appendagitis (PEA) is an inflammatory disease occurs due to the torsion or spontaneous venous thrombosis of colonic epiploic appendages. Frequency of PEA is greater in the sigmoid colon, which is the place where appendix epiploica most commonly observed. Cecal PEA is seen rarely. PEA is actually a disease that can be cured by conservative treatment. However, cecal epiploic appendagitis is sometimes managed by surgical treatment because it mimics acute abdomen.Case Reports: Two epiploic appendagitis cases were reported in this article. These patients were presented to our emergency department with sign and symptoms of acute appendicitis. Surgical treatment was performed in both two patients, since epiploic appendagitis was not radiologically identified in either case preoperatively. Conclusion: Surgery is not necessary in the treatment of epiploic appendagitis. A careful radiological examination, especially a computed tomography, would increase the correct diagnosis of epiploic appendagitis cases and provide an opportunity for conservative treatment. On the other hand, if cecal epiploic appendagitis can not be diagnosed preoperatively by the radiologist, surgery will be inevitable because it mimics acute appendicitis.

Keywords

• Appendigitis, appendix epiploica, acute abdomen

Akut Apandisiti Taklit Eden Nadir Bir Patoloji; Epiploik Apandajit

Abstract

Amaç: Primer epiploik apandajit (PEA), kolonik apendiks epiploikaların torsiyonu ya da spontan venöz trombozu sonucunda gelişen enflamatuar bir hastalıktır. PEA sıklığı, apendiks epiploikaların en yaygın bulunduğu yer olan sigmoid kolonda fazladır. Çekal PEA nadiren görülür. PEA aslında konzervatif tedavilerle iyileşebilen bir hastalıktır. Ancak, çekal PEA bazen cerrahi olarak tedavi edilmektedir çünkü akut batını taklit etmektedir.Olgular: Bu makalede iki epiploik apandajit olgusu sunulmaktadır. Bu hastalar acil servise akut apandisit belirti ve bulguları ile başvurmuşlardı. Her iki hastaya da cerrahi tedavi uygulandı çünkü ikisinde de preoperatif epiploik apandajit tanısı radyolojik olarak konulamamıştı. Sonuç: Epiploik apandajit tedavisinde cerrahi gerekli değildir. Dikkatli bir radyolojik inceleme, özellikle bilgisayarlı tomografi, epiploik apandajit vakalarının doğru teşhis edilmesini arttıracaktır ve konzervatif tedavi şansı sağlayacaktır. Öte yandan, akut apandisiti taklit eden çekal epiploik apandajit tanısı radyolog tarafından preoperatif konulamazsa, cerrahi kaçınılmaz olacaktır.

Keywords

• Apandajit, Apendiks epiploika, Akut batın

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