title: The Diagnostic Dilemma of Primary Epiploic Appendagitis and How to Establish a Diagnosis.
abstract: Primary epiploic appendagitis (PEA) is a relatively uncommon, non-surgical situation that clinically mimics other conditions requiring surgery. In PEA, torsion and inflammation of an epiploic appendix results in localized abdominal pain. This condition may be clinically misdiagnosed, resulting in unnecessary surgical intervention. We report the unusual case of a healthy 44-year-old man, who presented to the 417 NIMTS Military Veterans' Fund Hospital of Athens with non-migratory left lower quadrant abdominal pain, which had started 24 hours before admission. The patient described a constant, sharp, non-radiating pain. He had no symptoms of nausea, vomiting, constipation, diarrhea, or fever. Abdominal examination showed focal abdominal tenderness with slight rebound tenderness. The diagnosis of PEA of the sigmoid colon was made based on the findings of an abdominal contrast computed tomography (CT). The key findings of CT were an oval lesion with a maximum diameter of 2.4 cm, with fat attenuation, and a circumferential hyperdense ring located adjacent to the sigmoid colon. This case is presented to highlight the clinical characteristics of PEA, which may help clinicians to overcome this diagnostic dilemma and reach the correct diagnosis.
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Athens, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Gourgiotis
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Athens, Greece.
authors.forename: Christianna
authors.initials: C
authors.lastname: Oikonomou
authors.affiliation: Radiology Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Veloudis
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Lardou
authors.affiliation: Radiology Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Pittaras
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Athens, Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Villias
keywords: Appendix Epiploica; Diagnosis; Inflammation; Radiology