Epiploic appendagitis: Difference between revisions
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==Background== | ==Background== | ||
*Benign and self-limited condition of the epiploic appendages (fat-filled sacs along surface of colon and rectum) | [[File:Gray1076.png|thumb|Anterior view of iliac colon, sigmoid colon, and rectum. Lumps of epiploic appendage fat visible on colon.]] | ||
*Benign and self-limited condition of the epiploic appendages (fat-filled sacs along surface of colon and rectum)<ref>Schnedl WJ, et al. Insights into epiploic appendagitis. Nat Rev Gastroenterol Hepatol. 2011; 8:45-59.</ref> | |||
*Acutely inflamed due to torsion or venous thrombosis | *Acutely inflamed due to torsion or venous thrombosis | ||
*Mimics [[Appendicitis]] or [[Diverticulitis]] | *Mimics [[Appendicitis]] or [[Diverticulitis]] | ||
| Line 8: | Line 9: | ||
==Clinical Features== | ==Clinical Features== | ||
*[[Abdominal pain]] | *[[Abdominal pain]] | ||
*May develop fever and leukocytosis | *May develop [[fever]] and [[leukocytosis]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
[[File:Epiploic Appendagitis .jpg|thumb|Abdominal CT scan showing epiploic appendagitis (circle).]] | |||
*CT abdomen with IV contrast | *CT abdomen with IV contrast | ||
==Management== | ==Management== | ||
*High dose [[ibuprofen]] | *High dose [[ibuprofen]] | ||
*Consider | *Consider [[opioids]] | ||
*Surgical intervention not routinely recommended | *Surgical intervention not routinely recommended | ||
==Disposition== | ==Disposition== | ||
*Outpatient | *Outpatient follow-up. | ||
*Although recurrence is common the disease is self limiting and not life threatening. | *Although recurrence is common the disease is self limiting and not life threatening. | ||
Latest revision as of 18:21, 8 July 2021
Background
- Benign and self-limited condition of the epiploic appendages (fat-filled sacs along surface of colon and rectum)[1]
- Acutely inflamed due to torsion or venous thrombosis
- Mimics Appendicitis or Diverticulitis
- Most often found on abdominal CT during abdominal pain workup
- More than half occur in rectosigmoid colon
Clinical Features
- Abdominal pain
- May develop fever and leukocytosis
Differential Diagnosis
RLQ Pain
- GI
- Appendicitis
- Perforated appendicitis
- Peritonitis
- Crohn's disease (terminal ileitis)
- Diverticulitis (cecal, Asian patients)
- Inguinal hernia
- Mesenteric ischemia
- Ischemic colitis
- Meckel's diverticulum
- Neutropenic enterocolitis (typhlitis)
- Appendicitis
- GU
- Other
Evaluation
- CT abdomen with IV contrast
Management
Disposition
- Outpatient follow-up.
- Although recurrence is common the disease is self limiting and not life threatening.
Prognosis
- Complete resolution normally within 3-14 days
References
- ↑ Schnedl WJ, et al. Insights into epiploic appendagitis. Nat Rev Gastroenterol Hepatol. 2011; 8:45-59.