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Differential diagnosis of left-sided abdominal pain:Primary epiploic appendagitis vs colonic diverticulitis

World Journal of Gastroenterology 2013年第40期19卷 6842-6848页

作者： Jeong Ah Hwang Sun Moon Kim Hyun Jung Song Yu Mi Lee Kyung Min Moon Chang Gi Moon Hoon Sup Koo Kyung Ho Song Yong Seok Kim Tae Hee Lee Kyu Chan Huh Young Woo Choi Young Woo Kang Woo Suk Chung Division of Gastroenterology and Hepatology Department of Internal MedicineKonyang University College of MedicineDaejeon 302-718South Korea Department of Diagnostic Radiology Konyang University College of MedicineDaejeon 302-718South Korea

AIM:To investigate the clinical characteristics of left primary epiploic appendagitis and to compare them with those of left colonic ***:We retrospectively reviewed the clinical records and radiologic images of the patients who presented with left-sided acute abdominal pain and had computer tomography(CT) performed at the time of presentation showing radiological signs of left primary epiploic appendagitis(PEA) or left acute colonic diverticulitis(ACD) between January 2001 and December 2011. A total of 53 consecutive patients were enrolled and evaluated. We also compared the clinical characteristics,laboratory findings,treatments,and clinical results of left PEA with those of left ***:Twenty-eight patients and twenty-five patients were diagnosed with symptomatic left PEA and ACD,respectively. The patients with left PEA had focal abdominal tenderness on the left lower quadrant(82.1%). On CT examination,most(89.3%) of the patients with left PEA were found to have an oval fatty mass with a hyperattenuated ring sign. In cases of left ACD,the patients presented with a more diffuse abdominal tenderness throughout the left side(52.0%vs 14.3%; P = 0.003). The patients with left ACD had fever and rebound tenderness more often than those with left PEA(40.0% vs 7.1%,P = 0.004; 52.0% vs14.3%,P = 0.003,respectively). Laboratory abnormalities such as leukocytosis were also more frequently observed in left ACD(52.0% vs 15.4%,P = 0.006).CONCLUSION:If patients have left-sided localized abdominal pain without associated symptoms or laboratory abnormalities,clinicians should suspect the diagnosis of PEA and consider a CT scan.

关键词： Acute abdomen Differential diagnosis Appendix epiploica Colonic diverticulitis Multidetector computed tomography

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Acute Epiploic Appendagitis of the Vermiform Appendix: Typical Computed Tomographic Image with Pathologic Correlation

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Advances in Computed Tomography 2017年第4期6卷 21-27页

作者： Jung Wook Seo Department of Radiology Ilsan Paik Hospital Inje University College of Medicine Goyang-Si Korea

Epiploic appendages can become ischemic and infarcted, which can present acute abdominal pain that mimics other diseases, such as diverticulitis or appendicitis. Particularly, inflammation of an epiploic appendage attached to the vermiform appendix is a very rare cause of acute abdominal pain, and it is difficult to diagnose this condition preoperatively. We present a case of epiploic appendagitis of the vermiform appendix that was identified with a typical radiologic image and was pathologically confirmed. In addition, we review the literature of similar cases and analyze the clinical and radiologic features of EA of the vermiform appendix.

关键词： Acute Abdomen Appendix epiploica epiploica Appendagitis Vermiform Appendix Computed Tomography

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