Torsion of epiploic appendage
mimic acute appendicitis.
We present a case in which a transverse colon epiploic appendage
adhesion to the ascending colon mesentery resulted in a closed loop obstruction mimicking a pericecal internal hernia.
Epiploic appendagitis (EA) is a rare cause of acute abdominal pain caused by inflammation of an epiploic appendage
. It has a nonspecific clinical presentation that may mimic other acute abdominal pathologies on physical exam, such as appendicitis, diverticulitis, or cholecystitis.
The affected epiploic appendage
, adherent to the colonic wall, is frequently found to be surrounded by a hypoechoic border during USG (1).
Each epiploic appendage
receives blood supply through the narrow stalk.
ligation and resection is rare and usually reserved for when conservative management fails or there is new or worsening symptoms such as fever, progressive pain, or refractory nausea and vomiting.
The most common etiologies of this entity are venous thrombosis (secondary) or torsion or incarceration of an epiploic appendage
within a hernia sac (primary).
It consists of a thin, round, or oval high-attenuation ring representing thickened, inflamed visceral peritoneum surrounding the torsed epiploic appendage
(Figure 26).75 Internally, the high-attenuation ring contains fat and often a central dot of high attenuation that represents the thrombosed central vein.
Epiploic appendagitis is the inflammation of epiploic appendages
due to appendageal torsion or spontaneous venous thrombosis (9).
are peritoneal pouches that arise from the serosal surface of the colon except the rectum.
Epiploic appendagitis is an uncommon condition involving inflammation of epiploic appendages
resulting from obstruction of blood flow within the tissue.
are peritoneal pouches (composed of adipose tissue) arising from the serosal surface of the colon, being attached by a vascular stalk.