title: Epiploic Appendagitis, an Uncommon Cause of Abdominal Pain: A Case Series and Review of the Literature.
abstract: OBJECTIVE
  Epiploic appendagitis (EA) is a rare entity caused by the inflammation of the appendix epiploica. It is a benign and self-limited condition presenting as acute onset abdominal pain. The inaccurate diagnosis of EA can lead to unnecessary hospitalization, antibiotic therapy, and surgery. Our aim is to describe the common clinical features of patients who were diagnosed with EA over a 2-year period at the San Juan Veterans Administration Hospital.
  
  
  METHODS
  A retrospective descriptive review of the records of all patients diagnosed with EA from 2007 to 2009. The clinical data was obtained through record review. Diagnoses were confirmed by 2 radiologists reviewing imaging studies.
  
  
  RESULTS
  Eight patients were included in the study. All were male with a mean age of 58 years. Seven patients were overweight as per body mass index (BMI) scale. All had localized focal, non-migratory abdominal pain, most (75%) in the left lower quadrant. Nausea (37.5%), anorexia (12.5%), constipation (12.5%), and diarrhea (25%) were documented as well. Only 2 patients demonstrated mild elevations in WBC, but none of the 8 had a fever. During the study period, all the patients' symptoms resolved without documented recurrence.
  
  
  CONCLUSIONS
  In our small case series, overweight was a common finding, supporting the described association between EA and obesity. History and physical exam should prompt the clinician to consider EA in the differential diagnosis of acute abdominal pain, particularly in those who are obese and who have pain localized to the left lower quadrant.
authors.affiliation: Trainee, GI Training Program, VACHS, San Juan, PR.
authors.forename: Hiram D
authors.initials: HD
authors.lastname: Ortega-Cruz
authors.affiliation: Associate Director of the GI Training Program, VACHS, San Juan, PR.
authors.forename: Jaime
authors.initials: J
authors.lastname: Martínez-Souss
authors.affiliation: Staff Radiologist, VACHS, San Juan, PR.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Acosta-Pumarejo
authors.affiliation: Chief of Medical Service and Director of the GI Training Program, VACHS, San Juan, PR; Professor, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Doris H
authors.initials: DH
authors.lastname: Toro
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies
keywords: Abdominal Pain; Appendix Epiploica; Colon