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A Rare Pathology Mimicing Acute Appendicitis; Epiploic Appendagitis

Year 2014, Volume: 4 Issue: 3, 135 - 138, 01.09.2014
https://doi.org/10.5505/sakaryamj.2014.53244

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.

References

  • van Breda Vriesman AC, de Mol van Otterloo AJ, Puylaert JB. Epiploic appendagitis and omental infarction. Eur J Surg, 2001. 167(10): p. 723-7.
  • Platts-Mills TF, Burg MD. Epiploic appendagitis. J Emerg Med, 2009. 37(3): p.308-9.
  • Legome EL, Sims C, Rao PM. Epiploic appendagitis: adding to the differential of acute abdominal pain. J Emerg Med, 1999. 17(5): p. 823-6.
  • Ozdemir S, Gulpinar K, Leventoglu S,et al. Torsion of the primary epiploic appendagitis: a case series and review of the literature. Am J Surg, 2010. 199(4): p. 453-8.
  • Hasbahceci M, Erol C, Seker M. Epiploic appendagitis: is there need for surgery to confirm diagnosis in spite of clinical and radiological findings? World J Surg, 2012. 36(2): p. 441-6.
  • Mollà E, Ripollés T, Martínez MJ, et al. Primary epiploic appendagitis: US and CT findings. Eur Radiol, 1998. 8(3): p. 435-8.
  • Macari M, Laks S, Hajdu C, et al. Caecal epiploic appendagitis: an unlikely occurrence. Clin Radiol, 2008. 63(8): p. 895-900.
  • Ozkurt H, Karatağ O, Karaarslan E, et al. Clinical and CT findings of epiploic appendagitis within an inguinal hernia. Diagn Interv Radiol, 2007. 13(1): p. 23-5.
  • Boulanger BR, Barnes S, Bernard AC. Epiploic appendagitis: an emerging diagnosis for general surgeons. Am Surg, 2002. 68(11): p. 1022-5.
  • Singh AK, Gervais DA, Hahn PF, et al. CT appearance of acute appendagitis. Am J Roentgenol, 2004. 183(5): p. 1303-7.
  • Schein M, Rosen A, Decker GA. Acute conditions affecting epiploic appendages. A report of 4 cases. S Afr Med J, 1987. 71(6): p. 397-8.
  • Thomas JH, Rosato FE, Patterson LT. Epiploic appendagitis. Surg Gynecol Obstet1974; 138: 23–25.
  • Singh AK, Gervais DA, Hahn PF, et al. Acute epiploic appendagitis and its mimics. Radiographics, 2005. 25(6): p. 1521-34.
  • Vinson D.R. Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review. J Emerg Med, 1999. 17(5): p. 827-32.

Akut Apandisiti Taklit Eden Nadir Bir Patoloji; Epiploik Apandajit

Year 2014, Volume: 4 Issue: 3, 135 - 138, 01.09.2014
https://doi.org/10.5505/sakaryamj.2014.53244

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.

References

  • van Breda Vriesman AC, de Mol van Otterloo AJ, Puylaert JB. Epiploic appendagitis and omental infarction. Eur J Surg, 2001. 167(10): p. 723-7.
  • Platts-Mills TF, Burg MD. Epiploic appendagitis. J Emerg Med, 2009. 37(3): p.308-9.
  • Legome EL, Sims C, Rao PM. Epiploic appendagitis: adding to the differential of acute abdominal pain. J Emerg Med, 1999. 17(5): p. 823-6.
  • Ozdemir S, Gulpinar K, Leventoglu S,et al. Torsion of the primary epiploic appendagitis: a case series and review of the literature. Am J Surg, 2010. 199(4): p. 453-8.
  • Hasbahceci M, Erol C, Seker M. Epiploic appendagitis: is there need for surgery to confirm diagnosis in spite of clinical and radiological findings? World J Surg, 2012. 36(2): p. 441-6.
  • Mollà E, Ripollés T, Martínez MJ, et al. Primary epiploic appendagitis: US and CT findings. Eur Radiol, 1998. 8(3): p. 435-8.
  • Macari M, Laks S, Hajdu C, et al. Caecal epiploic appendagitis: an unlikely occurrence. Clin Radiol, 2008. 63(8): p. 895-900.
  • Ozkurt H, Karatağ O, Karaarslan E, et al. Clinical and CT findings of epiploic appendagitis within an inguinal hernia. Diagn Interv Radiol, 2007. 13(1): p. 23-5.
  • Boulanger BR, Barnes S, Bernard AC. Epiploic appendagitis: an emerging diagnosis for general surgeons. Am Surg, 2002. 68(11): p. 1022-5.
  • Singh AK, Gervais DA, Hahn PF, et al. CT appearance of acute appendagitis. Am J Roentgenol, 2004. 183(5): p. 1303-7.
  • Schein M, Rosen A, Decker GA. Acute conditions affecting epiploic appendages. A report of 4 cases. S Afr Med J, 1987. 71(6): p. 397-8.
  • Thomas JH, Rosato FE, Patterson LT. Epiploic appendagitis. Surg Gynecol Obstet1974; 138: 23–25.
  • Singh AK, Gervais DA, Hahn PF, et al. Acute epiploic appendagitis and its mimics. Radiographics, 2005. 25(6): p. 1521-34.
  • Vinson D.R. Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review. J Emerg Med, 1999. 17(5): p. 827-32.
There are 14 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Hakan Özdemir This is me

Zehra Ünal Özdemir This is me

Metin Şenol This is me

İbrahim Tayfun Şahiner This is me

Publication Date September 1, 2014
Submission Date September 7, 2015
Published in Issue Year 2014 Volume: 4 Issue: 3

Cite

AMA Özdemir H, Özdemir ZÜ, Şenol M, Şahiner İT. Akut Apandisiti Taklit Eden Nadir Bir Patoloji; Epiploik Apandajit. Sakarya Tıp Dergisi. September 2014;4(3):135-138. doi:10.5505/sakaryamj.2014.53244

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