Epiploic appendagitis, an overlooked emergency in the daily practice

Öz

Introduction Acute epiploic appendagitis is an uncommon and easily misdiagnosed cause of acute abdominal pain. The diagnosis of epiploic appendagitis has clear clinical importance in patient management. In the case of acute abdominal pain, Radiology plays a critical role in the diagnosis of this condition, which often mimics other conditions that require surgical intervention. The aim of this article is to evaluate the frequency and presentation of acute epiploic appendicitis in our patient population and to remind them of this pathology. Materials and Methods Adult patients applied to the emergency department with acute abdominal pain and were evaluated with abdominal computed tomography (CT) between January 2022 and December 2022 were retrospectively analyzed. Patients were grouped according to the common causes of acute abdomen. The frequency and common presentation of epiploic appendagitis were researched. Results In the 1-year retrospective radiology database search, CT findings were consistent with epiploic appendicitis in 8 of 256 patients. The anamnesis, physical examination, and laboratory findings of these 8 patients were examined retrospectively. Conclusion Epiploic appendagitis is a rare but self-limiting cause of acute abdomen. In the management of acute abdominal pain, emergency physicians and radiologists should also remember this clinical situation in order to avoid unnecessary surgical interventions.

Anahtar Kelimeler

• acute abdomen
• computed tomography
• abdomen pain
• emergency

Epiploik apandisit, günlük protikte gözden kaçırılan acil bir durum

Öz

Amaç Akut epiploik apandisit, akut karın ağrısının nadir görülen ve kolaylıkla yanlış teşhis edilebilen bir nedenidir. Epiploik uzantıların benign, kendi kendini sınırlayan inflamatuar veya iskemik hasarı ile veya komşu karın organlarını etkileyen diğer inflamatuar durumlara sekonder olabilir. Epiploik apandisit teşhisinin hasta yönetiminde net bir klinik önemi vardır. Akut karın ağrısı durumunda akut apandisit ve divertikülit gibi genellikle cerrahi müdahale gerektiren diğer durumların taklitçisi olan bu durumun tanısında görüntüleme önemli bir rol oynar. Çalışmamızın amacı akut karın ağrısıyla gelen yetişkin hastalarda epiploik apandisit tanı oranını ve en sık tanısal yanılgıya neden olan patolojileri belirlemektir. Gereç ve Yöntemler 01.01.2022-31.12.2022 tarihleri arasında travma olmaksızın akut karın ağrısı nedeniyle acil servise başvuran ve tanı amacıyla abdomen bilgisayarlı tomografi (BT) tetkiki yapılan yetişkin hastalar retrospektif olarak incelendi. BT tetkiklerinde sık görülen akut abdomen nedenleri araştırılarak hastalar gruplandırıldı. The study was accepted by the decision number 2023/125 of the non-invasive clinical research ethics committee on 18.10.2023. Bulgular Bir yıllık sürede acil serviste akut karına tanısal yaklaşım amacıyla BT görüntüleme tetkiki yapılan 139’ u erkek olmak üzere toplam 256 hasta olduğu görüldü. Sık görülen akut karın nedenlerine göre BT bulguları gruplandırıldı. 256 hastanın 8’inde BT bulgularının epiploic apandisitle uyumlu olduğu görüldü. Bu 8 hastanın anamnez, fizik muayene ve laboratuvar bulguları retrospektif olarak incelendi. Sonuç Akut karın ağrısının tedavisinde gereksiz cerrahi girişimlerden kaçınmak için acil hekimleri ve radyologların sık rastlanmayan bu klinik durumu akılda tutması gerekmektedir.

Anahtar Kelimeler

• akut karın
• bilgisayarlı tomografi
• karın ağrısı

Kaynakça

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