Epiploic appendices are small lobular masses of fat emanating from the serosal surface of the col... more Epiploic appendices are small lobular masses of fat emanating from the serosal surface of the colon, normally identifiable by CT only when surrounded by peritoneal fluid. However, an inflamed appendage, which can result from appendageal torsion or thrombosis of an appendageal draining vein, has a characteristic appearance on CT. With the increasing use of CT in the diagnosis of abdominal pain, primary epiploic appendagitis (PEA), a relatively uncommon and benign condition, can now be identified by pathognomonic radiological findings, thus obviating the need for hospitalization, further studies, or surgical exploration. Based upon patient series, PEA is the correct diagnosis in 2-7% of presumed diverticulitis cases and 1% of presumed appendicitis cases (1, 2). Appropriate radiological diagnosis in the otherwise non-toxic-appearing patient allows the clinician to pursue conservative management, avoiding unnecessary intervention and cost. We report three recent cases of PEA presenting to our institution, describing their clinical symptoms, laboratory and CT findings, and follow-up examinations. CASE SERIES Patient 1. A 37-year-old otherwise healthy man presented to his local emergency department with severe right lower quadrant abdominal pain. He had no associated fever, nausea, vomiting, diarrhea, or hematuria. An abdominal CT was obtained and reported to demonstrate inflammation surrounding the right colon.
Epiploic appendices are small lobular masses of fat emanating from the serosal surface of the col... more Epiploic appendices are small lobular masses of fat emanating from the serosal surface of the colon, normally identifiable by CT only when surrounded by peritoneal fluid. However, an inflamed appendage, which can result from appendageal torsion or thrombosis of an appendageal draining vein, has a characteristic appearance on CT. With the increasing use of CT in the diagnosis of abdominal pain, primary epiploic appendagitis (PEA), a relatively uncommon and benign condition, can now be identified by pathognomonic radiological findings, thus obviating the need for hospitalization, further studies, or surgical exploration. Based upon patient series, PEA is the correct diagnosis in 2-7% of presumed diverticulitis cases and 1% of presumed appendicitis cases (1, 2). Appropriate radiological diagnosis in the otherwise non-toxic-appearing patient allows the clinician to pursue conservative management, avoiding unnecessary intervention and cost. We report three recent cases of PEA presenting to our institution, describing their clinical symptoms, laboratory and CT findings, and follow-up examinations. CASE SERIES Patient 1. A 37-year-old otherwise healthy man presented to his local emergency department with severe right lower quadrant abdominal pain. He had no associated fever, nausea, vomiting, diarrhea, or hematuria. An abdominal CT was obtained and reported to demonstrate inflammation surrounding the right colon.
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Papers by Jorge Soto