Inflammation of an epiploic appendage (appendix epiploicae [NA6]), which is a rare cause of focal abdominal pain in otherwise healthy patients; it may be asymptomatic or clinically mimic diverticulitis or appendicitis.
1) Epiploic appendagitis has a predominance for the cecum and sigmoid colon.
1) Epiploic appendagitis has a characteristic CT appearance described as an oval fatty mass measuring 1-4 cm in diameter of increased attenuation relative to normal fat.
Segmental omental infarction can be differentiated from epiploic appendagitis by its heterogeneous appearance, medial location with respect to the ascending and descending bowel, and lack of peripheral enhancement.
Secondary epiploic appendagitis is caused by inflammation of adjacent organs, most commonly due to diverticulitis.
Acute epiploic appendagitis may clinically mimic acute diverticulitis or acute appendicitis, as patients frequently present with acute onset, lower-quadrant pain though they are commonly afebrile and without leukocytosis.
Important clinical and radiologic mimics of acute epiploic appendagitis include acute appendicitis, acute diverticulitis, and omental infarct.
By recognizing typical imaging features of epiploic appendagitis, the radiologist plays a central role in preventing needless surgery and facilitating appropriate, conservative management.