Epiploic appendagitis: Difference between revisions

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==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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==Management==
==Management==
*High dose [[ibuprofen]]
*High dose [[ibuprofen]]
*Consider narcotic medication (usually start with acetaminophen/codeine)
*Consider [[opioids]]
*Surgical intervention not routinely recommended
*Surgical intervention not routinely recommended


==Disposition==
==Disposition==
*Outpatient followup.
*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.



Revision as of 20:32, 29 September 2019

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

Differential Diagnosis

RLQ Pain

Evaluation

  • CT abdomen with IV contrast

Management

  • High dose ibuprofen
  • Consider opioids
  • Surgical intervention not routinely recommended

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

  1. Schnedl WJ, et al. Insights into epiploic appendagitis. Nat Rev Gastroenterol Hepatol. 2011; 8:45-59.