Korean J Gastroenterol.  2002 Jul;40(1):41-45.

Primary Epiploic Appendagitis: Differential Diagnosis of Acute Abdomen and Usefulness of Abdominal Ultrasonography

• Baik GH
• Kim JH
• Baek IH
• Hahn TH
• Park HJ
• Kim JB
• Park SH
• Lee JM
• Kim DJ
• Park CK
• Lee KS

Abstract

BACKGROUNDS/AIMS: Primary epiploic appendagitis (PEA) is a relatively rare cause among many acute intra-abdominal conditions. Thus, it is rarely considered in the differential diagnosis of intra-abdominal disease.
METHODS
Seventeen patients who were diagnosed as having PEA from August 1999 to December 2001 were involved in this study. Their medical records were analyzed to study the clinical and radiological characteristics of PEA.
RESULTS
There were 13 men and 4 women with a mean age of 34 years. Regardless of rebound tenderness, all patients presented with a well localized left or right lower quadrant pain. The associated symptoms were nausea and diarrhea. Only one patient showed leukocytosis. All patients were diagnosed primarily by abdominal ultrasonography. In all cases, abdominal ultrasonography showed a hyperechoic nodule having a peripheral hypoechoic rim underneath the anterior abdominal wall at the site of maximum tenderness. The nodules were non-compressible and connected with the adjacent colon. CT scans for confirmatory diagnosis were performed in 16 patients. The symptoms disappeared within 1 week regardless of antibiotic treatment.
CONCLUSIONS
PEA is a rare cause of acute abdomen that can be diagnosed easily by ultrasonography.

Keyword

Primary epiploic appendagitis; Abdomen; acute; Ultrasonography

MeSH Terms

Abdomen
Abdomen, Acute*
Abdominal Wall
Colon
Diagnosis
Diagnosis, Differential*
Diarrhea
Female
Humans
Leukocytosis
Male
Medical Records
Nausea
Peas
Tomography, X-Ray Computed
Ultrasonography*