title: Epiploic appendagitis: an uncommon and easily misdiagnosed disease.
abstract: OBJECTIVE
  Epiploic appendagitis (EA) is a rare cause of focal abdominal pain in otherwise healthy patients. It may mimic diverticulitis, appendicitis or mesenteric infarction on clinical manifestation. The diagnosis of EA is very infrequent due in part to low awareness by clinical physicians. The aim of this study was to review and describe the clinical presentation and computed tomography (CT) findings of EA.
  
  
  METHODS
  Twenty-one patients (6 women and 15 men, average age 40 years [range 27-65 years]) were diagnosed with EA by CT between January 2006 and October 2009. The patients' medical records were retrospectively reviewed with regard to their socioeconomic data, characteristics of abdominal pain, associated symptoms, laboratory results, radiological findings and treatment.
  
  
  RESULTS
  Abdominal pain was the leading symptom. The pain was localized in the left lower quadrant (17 patients, 81.0%), left middle abdomen (2 patients, 9.5%) and right lower quadrant (2 patients, 9.5%), respectively. Leukocytosis (white blood cell > 10 × 10(9) /L) without left shift was found in 6 patients but all patients were afebrile. Characteristic CT findings of paracolonic oval hypodense fat tissue with thickened peritoneal ring and periappendageal fat stranding were all presented in 21 patients, but the central dot sign was presented in only 7 patients. They were all treated was conservative therapy.
  
  
  CONCLUSIONS
  Epiploic appendagitis is the inflammatory response of an appendage to infarction or spontaneous venous thrombosis. A CT scan provides a definite diagnosis of epiploic appendagitis, thus avoiding unnecessary surgical intervention and antibiotics.
authors: Division of Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, China.
authors: Jui-Hao
authors: JH
authors: Chen
authors: Chin-Chu
authors: CC
authors: Wu
authors: Ping-Hsiu
authors: PH
authors: Wu
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004238:Diverticulitis / Q000175:diagnosis; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis; D008297:Male; D065666:Mesenteric Ischemia; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging