Epiploic appendagitis

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 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

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