Clinical Characteristics of Primary Epiploic Appendagitis

Kim, Joo Sung; Lee, Jun Haeng; Son, Hee Jung; Lee, Soon Jin; Rhee, Poong Lyul; Kim, Jae J; Koh, Kwang Cheol; Paik, Seung Woon; Rhee, Jong Chul; Choi, Kyoo Wan

Abstract

BACKGROUND/AIMS: Primary epiploic appendagitis (PEA) is an uncommon cause of abdominal pain due to either appendageal torsion or spontaneous thrombosis of an appendageal draining vein. PEA is frequently misdiagnosed as either appendicitis or diverticulitis depending on its locations.
METHODS
Clinical and radiological characteristics of 8 cases of PEA were retrospectively reviewed.
RESULTS
All the patients were male and the mean age was 34.9+/-13.0 years. The chief complaint was sudden left (7 cases) or right (1 case) low quadrant pain. The patients did not appear ill and well-localized tenderness with or without rebound tenderness was usual physical finding. The results of blood tests were normal except leukocytosis in one patient. PEA was diagnosed by radiological examinations. CT scan showed pedunculated oval fatty masses with surrounding streaky densities connected to the serosal surface of the adjacent colon, The symptoms were disappeared within one week (mean 4.7 days) with or without antibiotic treatment. None of the patients underwent operation.
CONCLUSIONS
Though PEA presents nonspecific symptoms, it is a self-limiting disease which can be confirmatively diagnosed by CT scan and treated medically without antibiotics.