Epiploic Appendagitis: A Rare Disease with a Common Symptom

Epiploic appendagitis is one of the self-limiting rare causes of acute abdominal pain that is caused by torsion or accidental necrosis of one of the epiploic appendix of the colon. Due to the absence of specific clinical findings for this disease, it is usually diagnosed by chance in examinations for the cause. The use of radiologic methods in diagnosis is very helpful. The importance of the topic is that, with appropriate diagnosis, unnecessary surgeries are prevented and the patient will fully recover with conservative treatment. This study introduces a 32-year-old man attending emergency department in Sari Imam Khomeini Hospital because of acute lowe left abdominal pain. In examination abdominal tenderness was found in the superficial and deep palpation of the left lower quadrant of the abdomen. Ultrasound scan showed an echogenic mass without vascular flow adjacent to the descending colon. Also, CT scan revealed an ipsilateral fat-density elliptical lesion along the sigmoid colon with fat stranding around the lesion without increase in thickness of the adjacent intestinal wall. The findings were diagnostic of epiploic appendagitis, and the patient's symptoms improved with medical treatment. According to this report, epiploic appendagitis should be considered in differential diagnosis of abdominal pain in relatively young patients with acute abdominal pain.