Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Medical Student, Royal College of Surgeons in Ireland, Dublin, Ireland
Clin Med Res. 2023 Sep;21(3):159-162. doi: 10.3121/cmr.2023.1837.
Epiploic appendagitis is a rare cause of acute lower abdominal pain. Epiploic appendices are fat-filled serosal outpouchings of the cecum and sigmoid colon. Primary epiploic appendagitis (PEA) is characterized by epiploic inflammation caused by torsion of the appendage leading to ischemia or thrombosis of the appendage draining vein. Secondary epiploic appendagitis occurs in association with other inflammatory conditions of the abdomen or pelvis, most commonly diverticulitis. PEA is an important clinical mimicker of more severe causes of acute abdominal pain, such as diverticulitis, appendicitis, or gynaecological causes. The ease of access to computed tomography (CT), the diagnostic test of choice, has resulted in increased recognition of PEA. The classic CT findings of PEA are an ovoid mass measuring between 1.5 and 3.5 cm surrounded by a hyperattenuating/hyperdense ring with a centrally located hyperdense area. It is important to diagnose PEA as it is self-limiting and the correct diagnosis can prevent unnecessary hospital admission, antibiotic use, or even surgical intervention. We present a case of a 65-year-old male with a history of diverticulitis, presenting with left lower quadrant abdominal pain who was diagnosed with PEA based on CT and successfully managed with conservative treatment.
盲肠和乙状结肠的浆膜外脂肪膨出物即为阑尾，阑尾炎是一种罕见的导致急性下腹痛的原因。阑尾炎主要表现为阑尾炎症，由阑尾扭转引起，导致阑尾引流静脉缺血或血栓形成。继发性阑尾炎常与腹部或骨盆的其他炎症性疾病相关，最常见的是憩室炎。阑尾炎是一种重要的临床模拟疾病，容易误诊为更严重的急性腹痛原因，如憩室炎、阑尾炎或妇科原因。由于计算机断层扫描（CT）易于获取，且为首选诊断检查，因此，阑尾炎的检出率增加。阑尾炎的典型 CT 表现为卵圆形肿块，大小在 1.5 至 3.5 厘米之间，周围有一个高衰减/高密度环，中央有一个高密度区。诊断阑尾炎非常重要，因为它是自限性的，正确的诊断可以防止不必要的住院、抗生素使用，甚至手术干预。我们介绍了一位 65 岁男性患者的病例，该患者有憩室炎病史，表现为左下腹疼痛，根据 CT 诊断为阑尾炎，并通过保守治疗成功治疗。
