Hiller N, Berelowitz D, Hadas-Halpern I
Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel.
Isr Med Assoc J. 2000 Dec;2(12):896-8.
Primary epiploic appendagitis is a relatively rare condition in which torsion and inflammation of an epiploic appendix result in localized abdominal pain. This is a non-surgical situation that clinically mimics other conditions requiring surgery such as acute diverticulitis or appendicitis.
To investigate the clinical, laboratory and radiological findings of the disease.
During the years 1995-88 five patients with primary epiploic appendigitis were diagnosed at our institution. The clinical, laboratory and imaging results were summarized and compared to previously reported series. Emphasis was placed on the computed tomography findings, which are the gold standard for diagnosis.
All our patients (two males and three females, mean age 47 years) presented with left lower quadrant abdominal pain. CT proved to be the imaging modality of choice in all patients by showing a pericolic fatty mass with an increased attenuation as compared to normal abdominal fat. In all cases the mass was surrounded by a high attenuation rim, and focal stranding of the fat was observed. In no case was there thickening of the adjacent bowel wall. This serves as an important, and previously unreported, clue for diagnosis.
Primary epiploic appendagitis is a relatively rare condition that may be clinically misdiagnosed, resulting in unnecessary surgical intervention. Judicious interpretation of CT may lead to early diagnosis and ensure proper conservative treatment.
原发性网膜附件炎是一种相对罕见的病症，其中网膜附件的扭转和炎症会导致局部腹痛。这是一种非手术情况，临床上会与其他需要手术的病症（如急性憩室炎或阑尾炎）相混淆。
研究该疾病的临床、实验室及影像学表现。
在1985年至1988年间，我院诊断出5例原发性网膜附件炎患者。总结了他们的临床、实验室及影像学检查结果，并与先前报道的病例系列进行比较。重点关注计算机断层扫描（CT）结果，其是诊断的金标准。
我们所有的患者（2名男性和3名女性，平均年龄47岁）均表现为左下腹疼痛。CT显示结肠旁脂肪块，其衰减程度高于正常腹部脂肪，被证明是所有患者首选的成像方式。在所有病例中，肿块均被高衰减边缘所包围，且观察到脂肪有局灶性条索状改变。在所有病例中，相邻肠壁均未增厚。这是一个重要的、先前未报道过的诊断线索。
原发性网膜附件炎是一种相对罕见的病症，临床上可能会被误诊，从而导致不必要的手术干预。对CT进行合理解读可能会实现早期诊断并确保恰当的保守治疗。
