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Case: Epiploic Appendagitis

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Here we have a CT scan of the abdomen and pelvis

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in a patient with left lower quadrant pain.

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With contrast, we can see that

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the liver is a little fatty here.

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It's a little lower in attenuation than the spleen.

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I'm not gonna measure it, but I think

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my eyeballs can do a good job at that.

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The pancreas looks okay.

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The kidneys are without evidence of hydronephrosis.

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Small bowel.

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Looks pretty good.

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Ooh, I even get to see the appendix over there.

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That's kind of cute.

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But as we come down, we see a lot of

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inflammation in the left lower quadrant, but it

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doesn't look like our typical diverticulitis.

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You can see that the wall of the colon is

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not particularly thickened and that I don't

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see any diverticulum in that location either.

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Notice that this inflammation is on one

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side of the colon, not posterior to it,

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so there's one focal region of inflammation.

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And notice that that inflammation is

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centered around this kind of fat looking

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attenuation anterior to the colon

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with a bit of a thick appearance as well,

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and maybe even some central attenuation.

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Let's look at on coronal.

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As we come forward, we see just this little

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fatty globule in there with a significant amount

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of inflammation and this is epiploic appendagitis.

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Now I cannot spell that,

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but I can say it, so that's good.

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And this is an entity where these small little

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epiploic appendages that come off the colon will twist and

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result in inflammatory change and significant pain.

Report

Faculty

Laura L Avery, MD

Assistant Professor of Emergency Radiology Harvard Medical School

Massachusetts General Hosptial

Tags

Peritoneum/Mesentery

Non-infectious Inflammatory

Gastrointestinal (GI)

Emergency

CT

Body

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