CT appearance of acute appendagitis.
OBJECTIVE
Our aim was to describe the spectrum of CT findings in patients with acute epiploic appendagitis and also to evaluate the changes seen with this condition.


METHODS
Fifty patients diagnosed with acute epiploic appendagitis seen on contrast-enhanced CT were included in this study. The CT scans of the epiploic appendagitis were evaluated for the presence of colon wall thickening, a focal fatty center, inflammatory changes, location in relationship to the colon, size, and presence or absence of central high density within the fat. In 10 patients, the initial findings were compared with findings of follow-up CT performed between 3 days-21 months after the first CT.


RESULTS
The most common part of colon involved by acute epiploic appendagitis was the sigmoid colon (31/50), and the most common position was anterior to the colonic lumen (41/50). All 50 patients with acute epiploic appendagitis had a central fatty core surrounded by inflammation. Colon wall thickening was present in only two, and a central high-density focus was noted only in 27 of 50 patients. In 86% (43/50) of patients, the fatty central core was between 1.5 and 3.5 cm in length. The changes seen on follow-up CT varied, including increased density with a decrease in the size of the fatty central core, no change, complete resolution of findings, and minimal residual density.


CONCLUSIONS
On CT, acute epiploic appendagitis has a predictable appearance in terms of location, size, and density. The most common finding on CT is a fat-density oval lesion with surrounding inflammation on the anterior aspect of the sigmoid colon. The changes on CT are not predictable in the 2-week to 6-month window.
Singh
Ajay K
AK
Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Gervais
Debra A
DA
Hahn
Peter F
PF
Rhea
James
J
Mueller
Peter R
PR
D000006:Abdomen, Acute / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003092:Colitis / Q000150:complications / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D003287:Contrast Media