Alhazmi Ahmad, de Carvalho Fischer Cynthia, Schaafs Lars-Arne, Seifarth Claudia
Klinik für Allgemein- und Viszeralchirurgie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
Chirurgie (Heidelb). 2023 Nov;94(11):954-958. doi: 10.1007/s00104-023-01960-4. Epub 2023 Sep 12.
Epiploic appendagitis (AE) is a rare cause of acute abdomen and is often misdiagnosed as other common causes of acute abdomen, such as acute appendicitis, cholecystitis or diverticulitis due to its low incidence and its nonspecific clinical picture. This study presents the clinical course of AE and typical radiological features for an early and correct diagnosis in order to emphasize the importance of an early and correct diagnosis of AE.
This is a retrospective review of 43 patients diagnosed with AE between June 2010 and September 2022 at the Charité - University Hospital Berlin, Campus Benjamin Franklin. The medical records were reviewed regarding clinical und radiological features, anatomical location of the AE und treatment methods.
A total of 43 patients (29 male, 11 female) were diagnosed with AE and almost all patients presented with abdominal pain, except in 8 cases (18.6%). Specific findings in computer tomography (CT) with a typical picture of AE were found in 33 patients (76.7%). AE was mostly localized in the left colon: 12 were found in the sigmoid colon (27.9%), 16 in the descending colon (37.2%) and 5 at the junction of the descending colon and the sigmoid colon (11.6%). Of the patients 28 (65.1%) were admitted for conservative treatment and the rest of the patients were treated as outpatients. No patient underwent surgery, all were treated with analgesics (NSAID) and 17 patients received antibiotics in addition.
AE is a self-limiting disease and a common mimic of other serious causes of abdominal pain. Due to the emergence of the widespread use of imaging modalities, an early diagnosis of AE and a conservative approach as first choice of treatment in patients with AE could be established.
网膜附件炎（AE）是急性腹痛的罕见病因，由于其发病率低且临床表现不具特异性，常被误诊为急性腹痛的其他常见病因，如急性阑尾炎、胆囊炎或憩室炎。本研究介绍了AE的临床病程及典型影像学特征，以便早期正确诊断，强调早期正确诊断AE的重要性。
这是一项对2010年6月至2022年9月期间在柏林夏里特大学医院本杰明·富兰克林校区确诊为AE的43例患者的回顾性研究。回顾了病历中的临床和影像学特征、AE的解剖位置及治疗方法。
共43例患者（29例男性，11例女性）被诊断为AE，除8例（18.6%）外，几乎所有患者均有腹痛症状。33例患者（76.7%）在计算机断层扫描（CT）中发现具有AE典型表现的特异性征象。AE大多位于左半结肠：12例位于乙状结肠（27.9%），16例位于降结肠（37.2%），5例位于降结肠与乙状结肠交界处（11.6%）。28例患者（65.1%）入院接受保守治疗，其余患者为门诊治疗。无患者接受手术，所有患者均接受了镇痛药（非甾体抗炎药）治疗，17例患者还接受了抗生素治疗。
AE是一种自限性疾病，常被误诊为其他严重腹痛病因。由于影像学检查手段的广泛应用，可实现AE的早期诊断，并确立对AE患者首选保守治疗的方法。
