Clinical surgery-InternationalTorsion of the primary epiploic appendagitis: a case series and review of the literature
Section snippets
Patients and Methods
Data for the presented cases were collected from Ufuk University Faculty of Medicine Department of Surgery (n = 2) and Ankara Guven Hospital Emergency Service (n = 10) between April 2002 and September 2008. Among 2,500 visits annually in each hospital, 12 patients (3 women and 9 men) were diagnosed with symptomatic EA, and the mean age was 40 years (range 18–82 years). All patients were evaluated by the same clinician (first author) and diagnosed as EA either in the emergency room or at final
Results
Patients presented at the hospital between 1 and 10 days after the initial symptoms had arisen. Most patients (n = 10) had dull, constant pain either in the right (n = 3 patients, 30%) or left lower quadrant (n = 7 patients, 70%). Most of them (n = 10) denied complaints such as anorexia, nausea, vomiting, diarrhea, hematochezia, melena, fever, chills, and sweats. In addition, 1 patient had recurrent urinary tract symptoms. Two patients had general abdominal pain with nausea and vomiting and
Comments
EA was first anatomically described by Vesalius in 1543, but their surgical significance was not realized until 1843 when Virchow suggested that their detachment might be a source of free intraperitoneal loose body.5, 6 EA is typically .5 to 5-cm long and 1 cm to 2 cm thick and has no known function. The total number is approximately 100 and generally located along the sigmoid colon (57%) and ileocecum (26%).7, 8, 9 Our study at this point showed that the sigmoid colon appears to be the most
Conclusions
Diagnosis and treatment of EA is still a challenge for surgeons because of its nonspecific signs and symptoms. However, the increasing use of abdominal CT scans in the diagnosis of abdominal pain is leading clinicians to become more familiar with this disease. Finally, we suggest that when combined with appropriate imaging techniques, EA patients with a consistent clinical history and physical examination have the opportunity to be managed conservatively.
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Cited by (43)
An Unusual Cause of Left Lower Quadrant Abdominal Pain
2020, GastroenterologyA pediatric case report of Epiploic appendagitis presented with abdominal pain
2020, International Journal of Surgery Case ReportsCitation Excerpt :Considering its mobility and narrow pedicle appendages are disposed to torsion leading to EA. EA can arise at any age, pediatric cases are very rare with no gender preponderance unlike in adults it is most likely in the 4th and 5th decades with men gender preponderance [9–11]. It is more associated with obesity and high abdominal adipose tissue [3,12–14] although some studies reported no association [7,15].
A case report of epiploic appendagitis as a mimic of acute cholecystitis
2018, International Journal of Surgery Case ReportsCitation Excerpt :Rarer occurrences occur in the ascending (9%), transverse (6%) and descending colon (2%) [13]. The pain is often characterized as dull, localized and without radiation [12]. Rarely associated with other symptoms such as vomiting, bloating, diarrhea, and early satiety [11].
Acute epiploic appendigitis: Diagnostic and laparoscopic approach
2018, International Journal of Surgery Case ReportsCitation Excerpt :The inflammation is caused by either spontaneous torsion causing ischemia, hence gangrenous necrosis of the appendage or by primary thrombosis of the draining vein and inflammation [3]. The true incidence is unknown being more common in males in their second to fifth decades with a mean age of 40 [4]. We will discuss a case of a 24 year old male with acute epiploic appendagitis.
Evaluating the Patient with Left Lower Quadrant Abdominal Pain
2015, Radiologic Clinics of North AmericaCitation Excerpt :Typically, patients can pinpoint the location of the pain. A mild leukocytosis may be seen.83,84 Primary epiploic appendagitis occurs where there is torsion or spontaneous venous thrombosis of the involved appendage.81,85
Prevalence of SIRS with primary epiploic appendagitis
2024, Emergency Radiology