Mollà E, Ripollés T, Martínez M J, Morote V, Roselló-Sastre E
Department of Radiology, Hospital Dr. Peset, C/ Gaspar Aguilar, 90, E-46017 Valencia, Spain.
Eur Radiol. 1998;8(3):435-8. doi: 10.1007/s003300050408.
A retrospective review is presented of seven cases of epiploic appendagitis, with surgical confirmation in one case. The main clinico-analytical data and the US and CT findings are described, as well as the histopathologic features in the sole case that underwent surgical resection. We also calculated the frequency of this entity in patients undergoing emergency abdominal US on clinical suspicion of diverticulitis. In all seven cases the clinico-analytical evidence was nonspecific (localized acute abdominal pain and slight leukocytosis), mimicking in six cases the clinical presentation of sigmoid diverticulitis and in one case that of acute appendicitis. US imaging findings were characteristic: a hyperechoic mass localized under the point of maximum pain, adjacent to the anterior peritoneal wall and fixed during deep breathing. In none of the cases did color Doppler US show flow. CT findings were also typical and showed a mass with a peripheral hyperattenuated rim surrounding an area of fatty attenuation. Overall 7.1 % of patients investigated to exclude sigmoid diverticulitis finally showed findings of primary epiploic appendagitis. Primary epiploic appendagitis thus shows characteristic US and CT findings that allow its diagnosis and follow-up. This entity is much more frequent than previously reported, especially in patients referred for US to exclude sigmoid diverticulitis.
本文对7例网膜附件炎病例进行了回顾性分析，其中1例经手术确诊。描述了主要的临床分析数据、超声和CT检查结果，以及唯一接受手术切除病例的组织病理学特征。我们还计算了临床怀疑为憩室炎而接受急诊腹部超声检查的患者中该疾病的发生率。在所有7例病例中，临床分析证据均不具有特异性（局限性急性腹痛和轻度白细胞增多），其中6例临床表现类似乙状结肠憩室炎，1例类似急性阑尾炎。超声成像表现具有特征性：在最大疼痛点下方可见一高回声肿块，紧邻前腹壁，深呼吸时固定不动。所有病例彩色多普勒超声均未显示血流信号。CT表现也具有典型性，显示肿块周围有高密度边缘环绕着脂肪密度减低区。总体而言，在接受检查以排除乙状结肠憩室炎的患者中，7.1%最终显示为原发性网膜附件炎。原发性网膜附件炎具有特征性的超声和CT表现，有助于其诊断和随访。该疾病比以前报道的更为常见，尤其是在因超声检查而转诊以排除乙状结肠憩室炎的患者中。
