title: Epiploic appendagitis in a 27-year-old man.
abstract: BACKGROUND
  Epiploic appendagitis is an ischemic infarction of an epiploic appendage caused by torsion or spontaneous thrombosis of the central draining vein. Epiploic appendagitis is self-limited without surgery, and it is imperative for clinicians to be familiar with this entity.
  
  
  METHODS
  A healthy 27-year-old man was admitted due to acute right lower quadrant abdominal pain. Physical examination showed focal abdominal tenderness with slight rebound tenderness. Laboratory tests showed leukocytosis and an increased serum C-reactive protein level. Computed tomography (CT) showed a fatty ovoid pericolonic mass measuring 12 mm in diameter, with a circumferential hyperdense ring that abutted on the ascending colon and was surrounded by ill-defined fat stranding with a hyperdense ring. These findings were diagnostic of primary epiploic appendagitis. The patient was given high-dose antibiotics due to the secondary inflammation involving the parietal peritoneum.
  
  
  CONCLUSIONS
  Epiploic appendagitis presents with an abrupt onset of focal abdominal pain and tenderness without significant guarding or rigidity; it is an uncommon and difficult diagnosis. With awareness of this condition, however, evaluation by CT can provide an accurate diagnosis of epiploic appendagitis, distinguishing it from conditions with clinically overlapping manifestations.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Uehara
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yamaguchi
authors.forename: Ken
authors.initials: K
authors.lastname: Ohnita
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Fujita
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Masataka
authors.initials: M
authors.lastname: Uetani
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D000273:Adipose Tissue / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D044682:Colon, Ascending / Q000473:pathology*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D010666:Phenylpropionates / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000150:complications / Q000175:diagnosis*
chemical_list: D010666:Phenylpropionates; C040656:loxoprofen; D002097:C-Reactive Protein