Department of General Surgery, Umraniye Education and Research Hospital, Hirka-i Serif M Kececi Cesmesi S Doktorlar S B Bl 6/7, Fatih, 34291, Istanbul, Turkey.
World J Surg. 2012 Feb;36(2):441-6. doi: 10.1007/s00268-011-1382-2.
The present retrospective study was conducted to review the authors' experience and describe clinical and radiologic features of epiploic appendagitis (EA), which is an uncommon, self-limiting clinical entity mimicking acute appendicitis and diverticulitis. Awareness of the features of EA would allow a correct diagnosis and avoid unnecessary surgical interventions.
Patients diagnosed as EA in one regional medical center between June 2006 and June 2010 were included. Clinical, laboratory, and imaging features of EA were studied, with particular attention to its unique radiologic appearances.
Twenty patients (13 men and 7 women; average age 43.2 years) diagnosed with EA were included in the study. Localized abdominal pain without nausea, vomiting, and fever were the major presenting symptoms for all patients. Laboratory blood tests were normal, except in one patient with leukocytosis and two patients with increased serum C-reactive protein (CRP) levels. A noncompressible hyperechoic ovoid mass with hypoechoic border and without central blood flow on Doppler ultrasound (US) was detected in five of six patients. In all patients, the computed tomography (CT) scans revealed an ovoid fatty mass with hyperattenuating rim and disproportionate adjacent fat stranding. Central dot sign, concomitant old infarct, and lobulation were present in 75%, 20%, and 10% of the patients, respectively. All of the patients were treated conservatively. No recurrences occurred during the follow-up period (average: 24.8 months) in 18 (90%) of the patients.
In patients with localized abdominal pain without other symptoms, diagnosis of EA should be considered. Recognizing the US and CT features of EA may allow an accurate diagnosis and avoid unnecessary surgery.
本回顾性研究旨在回顾作者的经验，并描述以酷似急性阑尾炎和憩室炎为表现的不常见的自限性临床实体- 阑尾附件炎（EA）的临床和放射学特征。了解 EA 的特征可做出正确诊断并避免不必要的手术干预。
纳入 2006 年 6 月至 2010 年 6 月期间在一家地区医疗中心诊断为 EA 的患者。研究 EA 的临床、实验室和影像学特征，特别注意其独特的影像学表现。
本研究纳入了 20 例 EA 患者（男 13 例，女 7 例；平均年龄 43.2 岁）。所有患者的主要表现为局限性腹痛，无恶心、呕吐和发热。实验室血检除 1 例白细胞增多和 2 例血清 C 反应蛋白（CRP）升高外均正常。6 例患者中有 5 例超声检查（US）显示非压缩性高回声卵圆形肿块，边界低回声，多普勒无血流。所有患者 CT 扫描均显示卵圆形脂肪肿块，边缘高衰减，伴不成比例的相邻脂肪条索征。75%、20%和 10%的患者分别存在中央点征、同时陈旧性梗死和分叶征。所有患者均接受保守治疗。18 例（90%）患者在随访期间（平均 24.8 个月）未复发。
对于无其他症状的局限性腹痛患者，应考虑 EA 诊断。认识到 EA 的 US 和 CT 特征可做出准确诊断并避免不必要的手术。
