title: Co-occurrence of carbohydrate malabsorption and primary epiploic appendagitis.
abstract: Unspecific abdominal complaints including bloating and irregular bowel movements may be caused by carbohydrate malabsorption syndromes, e.g., lactose and fructose malabsorption. These symptoms were investigated with hydrogen (H2) breath tests and correlated to carbohydrate malabsorption. During performing these H2-breath tests the patient presented with an acute, localized, non-migratory pain in the left lower abdominal quadrant. Primary epiploic appendagitis is a rare cause of abdominal acute or subacute complaints and diagnosis of primary epiploic appendagitis (PEA) is made when computed tomography reveals a characteristic lesion. We report on a patient with co-occurrence of lactose and fructose malabsorption, which was treated successfully with a diet free of culprit carbohydrates, with PEA recovering without medication or surgical treatment within few days. Since the abdominal unspecific symptoms had been present for months, they appeared not to be correlated to the acute localized abdominal pain, therefore we speculate on a random co-occurrence of combined carbohydrate malabsorption and PEA.
authors.affiliation: Wolfgang J Schnedl, Practice for General Internal Medicine, A-8600 Bruck, Austria.
authors.forename: Wolfgang J
authors.initials: WJ
authors.lastname: Schnedl
authors.affiliation: Wolfgang J Schnedl, Practice for General Internal Medicine, A-8600 Bruck, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Kalmar
authors.affiliation: Wolfgang J Schnedl, Practice for General Internal Medicine, A-8600 Bruck, Austria.
authors.forename: Harald
authors.initials: H
authors.lastname: Mangge
authors.affiliation: Wolfgang J Schnedl, Practice for General Internal Medicine, A-8600 Bruck, Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Krause
authors.affiliation: Wolfgang J Schnedl, Practice for General Internal Medicine, A-8600 Bruck, Austria.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Wallner-Liebmann
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001944:Breath Tests; D050528:Diet, Carbohydrate-Restricted; D004040:Dietary Carbohydrates / Q000378:metabolism*; D005632:Fructose / Q000378:metabolism*; D065569:Gastrointestinal Absorption; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000175:diagnosis; D007787:Lactose Intolerance / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy / Q000378:metabolism; D008286:Malabsorption Syndromes / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy / Q000378:metabolism; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D004040:Dietary Carbohydrates; D005632:Fructose
keywords: Carbohydrate malabsorption; Computed tomography; Fructose malabsorption; Lactose malabsorption; Primary epiploic appendagitis