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) | *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]] | ||
Revision as of 10:45, 4 January 2017
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
- High dose ibuprofen
- Consider narcotic medication (usually start with acetaminophen/codeine)
- Surgical intervention not routinely recommended
Disposition
- Outpatient followup.
- 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.