Nadida Dali, Amal Ali, Ines Marzouk, Makram Moussa, Amira Manamani, Leila Ben Farhat, Lotfi Hendaoui
Radiology department, University Hospital Mongi Slim, Tunisia.
Radiology department, University Hospital Mongi Slim, Tunisia.
Int J Surg Case Rep. 2016;28:219-222. doi: 10.1016/j.ijscr.2016.09.015. Epub 2016 Oct 6.
The aim of this work is to explain the clinical features and the imaging findings of primitive epiploic appendagitis in 12 patients.
Twelve patients were examined in 2 University hospitals between January 2011 and June 2016. Their medical charts have been reviewed. Nine patients have undergone enhanced CT examination and only two among them, have had at first an abdominal ultrasound.
The age ranged between 36 and 65 years old. All the patients consulted for an acute abdominal pain in most of the cases in the left iliac fossa with no elevated body temperature nor a significant elevation of the inflammation markers. Ultrasound features showed a hyper-echoic mass surrounded by a hypo-echoic peripheral ring. CT scan images showed a fat ovoid lesion that corresponds to the inflamed Appendix epiploica with a peripheral hyper-attenuating rim and in some cases the central "dot sign" referring to the thrombosed vessel. Only 4 patients underwent surgery.
For its non-specific clinical presentation, that can mimic other surgical affections, and its rather non-operative treatment, the diagnosis of epiploic appendagitis is crucial. Ultrasound and especially CT scan imaging are necessary for an accurate diagnosis.
本研究旨在阐述12例原发性网膜附件炎患者的临床特征及影像学表现。
2011年1月至2016年6月期间,两所大学医院对12例患者进行了检查。查阅了他们的病历。9例患者接受了增强CT检查,其中仅2例最初进行了腹部超声检查。
患者年龄在36至65岁之间。大多数患者因急性腹痛就诊,疼痛部位多在左下腹,体温未升高,炎症指标也无明显升高。超声特征显示高回声肿块周围有低回声外周环。CT扫描图像显示一个脂肪样椭圆形病变,对应于发炎的网膜附件,外周有高密度边缘,部分病例中央可见“点状征”,提示血管血栓形成。仅4例患者接受了手术。
由于网膜附件炎临床表现不具特异性,可类似其他外科疾病,且多采用非手术治疗,因此其诊断至关重要。超声尤其是CT扫描成像对于准确诊断是必要的。