El-Sawaf Yasser, Alzayani Salman, Saeed Nermin K, Bediwy Adel S, Elbeltagi Reem, Al-Roomi Khaldoon, Al-Beltagi Mohammed
Department of Tropical Medicine, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt.
Department of Gastroenterology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain.
World J Gastroenterol. 2025 Aug 28;31(32):109897. doi: 10.3748/wjg.v31.i32.109897.
Epiploic appendagitis is a rare, often underrecognized cause of acute abdominal pain. Misdiagnosis can lead to unnecessary hospitalization, antibiotic use, or surgical intervention. Advances in imaging have improved the recognition of this self-limiting condition, but clinical awareness remains critical.
To provide a comprehensive update on the epidemiology, anatomy, pathogenesis, clinical presentation, diagnostic strategies, differential diagnosis, and management of epiploic appendagitis, emphasizing its distinguishing features from other causes of acute abdomen.
A review of the literature was conducted, focusing on the clinical characteristics, imaging findings, differential diagnoses, and evidence-based management strategies for epiploic appendagitis.
Epiploic appendagitis typically presents with acute, localized, non-radiating abdominal pain without significant systemic symptoms. Diagnosis is heavily reliant on imaging, with computed tomography (CT) being the gold standard. Hallmark CT findings include a small, fat-density ovoid lesion adjacent to the colon, with the usual characteristic ring and dot signs. Differential diagnoses include mainly diverticulitis, appendicitis, omental infarction, and many other causes. Management is predominantly conservative with nonsteroidal anti-inflammatory drugs and observation, reserving surgical intervention for rare, complicated cases.
Recognizing the clinical and imaging features of epiploic appendagitis is essential to avoid unnecessary interventions. Increased clinician awareness, coupled with judicious use of imaging, facilitates timely diagnosis and appropriate management, ensuring optimal patient outcomes.
网膜附件炎是一种罕见的、常未被充分认识的急性腹痛病因。误诊可导致不必要的住院、抗生素使用或手术干预。影像学的进展提高了对这种自限性疾病的认识，但临床意识仍然至关重要。
全面更新网膜附件炎的流行病学、解剖学、发病机制、临床表现、诊断策略、鉴别诊断和管理，强调其与其他急腹症病因的区别特征。
对文献进行综述，重点关注网膜附件炎的临床特征、影像学表现、鉴别诊断和循证管理策略。
网膜附件炎通常表现为急性、局限性、无放射痛的腹痛，无明显全身症状。诊断严重依赖影像学检查，计算机断层扫描（CT）是金标准。CT的特征性表现包括结肠旁一个小的、脂肪密度的椭圆形病变，通常有特征性的环征和点征。鉴别诊断主要包括憩室炎、阑尾炎、网膜梗死和许多其他病因。治疗主要采用非甾体类抗炎药保守治疗并观察，对于罕见的复杂病例则采用手术干预。
认识网膜附件炎的临床和影像学特征对于避免不必要的干预至关重要。临床医生意识的提高，加上合理使用影像学检查，有助于及时诊断和适当管理，确保患者获得最佳预后。
