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Primary epiploic appendagitis: A retrospective analysis of clinical and tomographic findings in 14 patients

Yıl 2023, Cilt: 4 Sayı: 3, 186 - 191, 27.09.2023
https://doi.org/10.47482/acmr.1340949

Öz

Background: The aim of this study is to describe the clinical features and imaging findings of 14 patients diagnosed with primary epiploic appendagitis on computed tomography (CT).
Methods: Between January 2019 and August 2022, the hospital records of 14 patients were retrospectively reviewed. We recorded patients' age, gender, fever presence, blood leukocyte count (WBC), C-reactive Protein (CRP) level, localization of abdominal pain, the presence of nausea or vomiting, the involved part of the colon on CT, whether they received treatment or not, and whether they underwent surgery.
Results: This study included 14 patients, 8 male and 6 female. Their ages ranged from 27 to 63 years. All patients presented with acute abdominal pain in most cases, with no elevation in body temperature or significant increase in inflammation markers. CT scan images showed a fat oval lesion corresponding to the inflamed Appendix epiploica, with a peripheral hyper-attenuated frame and a central "dot" in some cases referring to the thrombosed vessel. The patients were successfully treated with conservative methods.
Conclusions: Epiploic appendagitis can mimic surgical diseases such as appendicitis and diverticulitis due to its non-specific clinical presentation. CT scan is essential in diagnosing this disease, which can be managed with more conservative treatment methods.

Kaynakça

  • Barbier C, Denny P, Pradoura JM, Bui P, Rieger A, Bazin C et al. Radiologic aspects of infarction of the appendix epiploica. J Radiol. 1998;79: 1479-1485.
  • Tan R, Parys S, Watanabe Y. Diagnosis and management of epiploic appendagitis: A single-institution 10-year experience. Pol Przegl Chir. 2021;93(6):20-24.
  • van Breda Vriesman AC, Lohle PN, Coerkamp EG, Puylaert JB. Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history. Eur Radiol. 1999;9(9):1886-92.
  • Doğan AN, Çakıroğlu B, Akça AH, Aksoy SH, Akar T. Primary epiploic appendagitis: evaluation of computed tomography findings in the differential diagnosis of patients that presented with acute abdominal pain. Eur Rev Med Pharmacol Sci. 2022;26(1):59-63.
  • Sandrasegaran K, Maglinte DD, Rajesh A, Akisik FM. Primary epiploic appendagitis: CT diagnosis. Emerg Radiol. 2004;11(1):9-14.
  • Gurses B, Ekci B, Akansel S, Kabakci N, Kucuk S, Kovanlikaya I. Primary epiploic appendagitis: the role of computed tomography in diagnosis. Australas Radiol. 2007;51:155-57.
  • Horton KM, Corl FM, Fishman EK. CT evaluation of the colon: inflammatory disease. Radiographics. 2000;20(2):399-418.
  • Dockerty MB, Lynn TE, Waugh JM. A clinicopathologic study of the epiploic appendages. Surg Gynecol Obstet. 1956;103(4):423-33.
  • Danielson K, Chernin MM, Amberg JR, Goff S, Durham JR. Epiploic appendicitis: CT characteristics. J Comput Assist Tomogr. 1986;10:142- 43.
  • Chan E, El-Banna A. A case report of epiploic appendagitis as a mimic of acute cholecystitis. Int J Surg Case Rep. 2018;53:327-29.
  • Almeida AT, Melão L, Viamonte B, Cunha R, Pereira JM. Epiploic appendagitis: an entity frequently unknown to clinicians—diagnostic imaging, pitfalls, and look-alikes. Am J Roentgenol. 2009;193:1243-51.
  • Saad J, Mustafa HA, Elsani AM, Alharbi F, Alghamdi S. Primary epiploic appendagitis: reconciling CT and clinical challenges. Indian J Gastroenterol. 2014;33(5):420-6.
  • Harling L, Peglow S, Eger K, March C, Croner RS, Meyer F. Acute epiploic appendagitis - a rare differential diagnosis of acute abdomen. Z Gastroenterol. 2023;61 (2):172-77.
  • Trovato P, Simonetti I, Verde F, Lomoro P, Vinci G, Tarotto L, et al. Acute epiploic appendagitis: ultrasound and computed tomography findings of a rare case of acute abdominal pain and the role of other imaging techniques. Pol J Radiol. 2020;85:e178-e182.
  • Kahveci S, Zitouni S, Abubakar AR, İkizceli T, Ozturk M, Aktürk A, et al. Primary epiploic appendagitis: Not rare but rarely diagnosed pathology. Curr Med Imaging. 2023;19(11):1279-85.
  • Giannis D, Matenoglou E, Sidiropoulou MS, Papalampros A, Schmitz R, Felekouras E, et al. Epiploic appendagitis: pathogenesis, clinical findings and imaging clues of a misdiagnosed mimicker. Ann Transl Med. 2019;7(24):814.
  • Mollà E, Ripollés T, Martínez MJ, Morote V, Roselló-Sastre E. Primary epiploic appendagitis: US and CT findings. Eur Radiol. 1998;8(3):435- 8.
  • Trovato P, Simonetti I, Verde F, Lomoro P, Vinci G, Tarotto L et al. Acute epiploic appendagitis: ultrasound and computed tomography findings of a rare case of acute abdominal pain and the role of other imaging techniques. Pol J Radiol. 2020;85:e178-e182.
  • Choi YU, Choi PW, Park YH, Kim JI, Heo TG, Park JH et al. Clinical characteristics of primary epiploic appendagitis. J Korean Soc Coloproctol. 2011; 27:114.
  • Giannis D, Matenoglou E, Sidiropoulou MS, Papalampros A, Schmitz R, Felekouras E et al. Epiploic appendagitis: pathogenesis, clinical findings and imaging clues of a misdiagnosed mimicker Ann Transl Med. 2019;7(24):814
  • Giambelluca D, Cannella R, Caruana G, Salvaggio L, Grassedonio E, Galia M, et al. CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. Insights Imaging. 2019;10(1):26.
  • Osada H, Ohno H, Watanabe W, Nakada K, Okada T, Yanagita H, et al. Multidetector computed tomography diagnosis of primary and secondary epiploic appendagitis. Radiat Med. 2008;26(10):582-6.
  • Sand M, Gelos M, Bechara FG, Sand D, Wiese H, Steinstraesser L et al. Epiploic appendagitis--clinical characteristics of an uncommon surgical diagnosis. BMC Surg. 2007;7:11.
  • Cirimele V, D’Amone G, Ricci M, Casati R, Ragone R, Redi A, et al. A rare cause of right-upper quadrant abdominal pain: Epiploic appendagitis of the hepatic flexure. Radiol Case Rep. 2023;18(10):3434- 37.
  • Öztaş M, Türkoğlu B, Öztas B, Alakuş Ü, Meral UM. Rare causes of acute abdomen and review of literature: Primary/secondary omental torsion, isolated segmental omental necrosis, and epiploic appendagitis. Ulus Travma Acil Cerrahi Derg. 2023;29(2):193-202.

Primer Epiploik Apandisit: Klinik Ve Tomografik Bulguların Retrospektif Analizi

Yıl 2023, Cilt: 4 Sayı: 3, 186 - 191, 27.09.2023
https://doi.org/10.47482/acmr.1340949

Öz

Arka plan: Bu çalışmanın amacı, bilgisayarlı tomografi (BT) ile primer epiploik apandisit tanısı alan 14 hastanın klinik özelliklerini ve görüntüleme bulgularını tanımlamaktır.

Gereç ve Yöntemler: Ocak 2019-Ağustos 2022 tarihleri arasında 14 hastanın hastane kayıtları retrospektif olarak incelendi. Hastaların yaşını, cinsiyetini, ateş varlığını, kan lökosit sayısını (WBC), C-reaktif Protein (CRP) seviyesini, karın ağrısının lokalizasyonunu, bulantı veya kusma olup olmadığını, BT'de kalın bağırsağın tutulmuş kısmının olup olmadığını ,tedavi görüp görmediği ve ameliyat olup olmadığı kaydettik.

Bulgular: Bu çalışmaya 8 erkek ve 6 kadın olmak üzere 14 hasta dahil edildi. Yaşları 27 ile 63 arasında değişiyordu. Tüm hastalar, çoğu durumda vücut ısısında yükselme veya enflamasyon belirteçlerinde önemli bir artış olmaksızın akut karın ağrısı ile başvurdu. BT tarama görüntüleri, periferik hiperdens bir çerçeve ve bazı durumlarda tromboze damara atıfta bulunan merkezi bir "nokta" ile inflame Appendix epiploica'ya karşılık gelen oval bir lezyon gösterdi. Hastalar konservatif yöntemlerle başarıyla tedavi edildi.

Sonuç: Epiploik apandisit, nonspesifik klinik prezentasyonu nedeniyle apandisit ve divertikülit gibi cerrahi hastalıkları taklit edebilir. Daha konservatif tedavi yöntemleri ile tedavi edilebilen bu hastalığın teşhisinde BT taraması esastır.

Kaynakça

  • Barbier C, Denny P, Pradoura JM, Bui P, Rieger A, Bazin C et al. Radiologic aspects of infarction of the appendix epiploica. J Radiol. 1998;79: 1479-1485.
  • Tan R, Parys S, Watanabe Y. Diagnosis and management of epiploic appendagitis: A single-institution 10-year experience. Pol Przegl Chir. 2021;93(6):20-24.
  • van Breda Vriesman AC, Lohle PN, Coerkamp EG, Puylaert JB. Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history. Eur Radiol. 1999;9(9):1886-92.
  • Doğan AN, Çakıroğlu B, Akça AH, Aksoy SH, Akar T. Primary epiploic appendagitis: evaluation of computed tomography findings in the differential diagnosis of patients that presented with acute abdominal pain. Eur Rev Med Pharmacol Sci. 2022;26(1):59-63.
  • Sandrasegaran K, Maglinte DD, Rajesh A, Akisik FM. Primary epiploic appendagitis: CT diagnosis. Emerg Radiol. 2004;11(1):9-14.
  • Gurses B, Ekci B, Akansel S, Kabakci N, Kucuk S, Kovanlikaya I. Primary epiploic appendagitis: the role of computed tomography in diagnosis. Australas Radiol. 2007;51:155-57.
  • Horton KM, Corl FM, Fishman EK. CT evaluation of the colon: inflammatory disease. Radiographics. 2000;20(2):399-418.
  • Dockerty MB, Lynn TE, Waugh JM. A clinicopathologic study of the epiploic appendages. Surg Gynecol Obstet. 1956;103(4):423-33.
  • Danielson K, Chernin MM, Amberg JR, Goff S, Durham JR. Epiploic appendicitis: CT characteristics. J Comput Assist Tomogr. 1986;10:142- 43.
  • Chan E, El-Banna A. A case report of epiploic appendagitis as a mimic of acute cholecystitis. Int J Surg Case Rep. 2018;53:327-29.
  • Almeida AT, Melão L, Viamonte B, Cunha R, Pereira JM. Epiploic appendagitis: an entity frequently unknown to clinicians—diagnostic imaging, pitfalls, and look-alikes. Am J Roentgenol. 2009;193:1243-51.
  • Saad J, Mustafa HA, Elsani AM, Alharbi F, Alghamdi S. Primary epiploic appendagitis: reconciling CT and clinical challenges. Indian J Gastroenterol. 2014;33(5):420-6.
  • Harling L, Peglow S, Eger K, March C, Croner RS, Meyer F. Acute epiploic appendagitis - a rare differential diagnosis of acute abdomen. Z Gastroenterol. 2023;61 (2):172-77.
  • Trovato P, Simonetti I, Verde F, Lomoro P, Vinci G, Tarotto L, et al. Acute epiploic appendagitis: ultrasound and computed tomography findings of a rare case of acute abdominal pain and the role of other imaging techniques. Pol J Radiol. 2020;85:e178-e182.
  • Kahveci S, Zitouni S, Abubakar AR, İkizceli T, Ozturk M, Aktürk A, et al. Primary epiploic appendagitis: Not rare but rarely diagnosed pathology. Curr Med Imaging. 2023;19(11):1279-85.
  • Giannis D, Matenoglou E, Sidiropoulou MS, Papalampros A, Schmitz R, Felekouras E, et al. Epiploic appendagitis: pathogenesis, clinical findings and imaging clues of a misdiagnosed mimicker. Ann Transl Med. 2019;7(24):814.
  • Mollà E, Ripollés T, Martínez MJ, Morote V, Roselló-Sastre E. Primary epiploic appendagitis: US and CT findings. Eur Radiol. 1998;8(3):435- 8.
  • Trovato P, Simonetti I, Verde F, Lomoro P, Vinci G, Tarotto L et al. Acute epiploic appendagitis: ultrasound and computed tomography findings of a rare case of acute abdominal pain and the role of other imaging techniques. Pol J Radiol. 2020;85:e178-e182.
  • Choi YU, Choi PW, Park YH, Kim JI, Heo TG, Park JH et al. Clinical characteristics of primary epiploic appendagitis. J Korean Soc Coloproctol. 2011; 27:114.
  • Giannis D, Matenoglou E, Sidiropoulou MS, Papalampros A, Schmitz R, Felekouras E et al. Epiploic appendagitis: pathogenesis, clinical findings and imaging clues of a misdiagnosed mimicker Ann Transl Med. 2019;7(24):814
  • Giambelluca D, Cannella R, Caruana G, Salvaggio L, Grassedonio E, Galia M, et al. CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. Insights Imaging. 2019;10(1):26.
  • Osada H, Ohno H, Watanabe W, Nakada K, Okada T, Yanagita H, et al. Multidetector computed tomography diagnosis of primary and secondary epiploic appendagitis. Radiat Med. 2008;26(10):582-6.
  • Sand M, Gelos M, Bechara FG, Sand D, Wiese H, Steinstraesser L et al. Epiploic appendagitis--clinical characteristics of an uncommon surgical diagnosis. BMC Surg. 2007;7:11.
  • Cirimele V, D’Amone G, Ricci M, Casati R, Ragone R, Redi A, et al. A rare cause of right-upper quadrant abdominal pain: Epiploic appendagitis of the hepatic flexure. Radiol Case Rep. 2023;18(10):3434- 37.
  • Öztaş M, Türkoğlu B, Öztas B, Alakuş Ü, Meral UM. Rare causes of acute abdomen and review of literature: Primary/secondary omental torsion, isolated segmental omental necrosis, and epiploic appendagitis. Ulus Travma Acil Cerrahi Derg. 2023;29(2):193-202.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme
Bölüm ORIGINAL ARTICLE
Yazarlar

Belma ÇEVİK
TUSAŞ Sağlık Merkezi
0000-0001-9616-8622
Türkiye


Benan KASAPOĞLU
LOKMAN HEKİM ÜNİVERSİTESİ
0000-0003-3858-0103
Türkiye

Yayımlanma Tarihi 27 Eylül 2023
Gönderilme Tarihi 10 Ağustos 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 4 Sayı: 3

Kaynak Göster

APA
ÇEVİK, B., & KASAPOĞLU, B. (2023). Primary epiploic appendagitis: A retrospective analysis of clinical and tomographic findings in 14 patients. Archives of Current Medical Research, 4(3), 186-191. https://doi.org/10.47482/acmr.1340949

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