A Case of Primary Epiploic Appendagitis of the Ascending Colon Diagnosed by Abdominal Enhanced Computed Tomography

Abstract

A 47-year-old man presented to the emergency department of our hospital, with a few days' history of right lower quadrant abdominal pain associated with nausea, chills and cold sweats. The pain was localized in the right lower quadrant, but there was no fever. Enhanced abdominal computed tomography showed a high-density lesion of fat tissue adjacent to the ascending colon, and we made the diagnosis of primary epiploic appendagitis of the ascending colon. The inflammation improved with antibiotic treatment initiated at the outpatient clinic. Primary epiploic appendagitis is a self-limiting disease with a good prognosis. The differential diagnosis includes acute appendicitis, because of the similar clinical course, and diverticulitis, because of the similar abdominal findings. As imaging often reveals characteristic findings in cases of epiploic appendagitis, this condition must be included in the differential diagnosis of patients presenting with acute abdomen, so that unnecessary surgery can be avoided. We have reported a case of primary epiploic appendagitis that was successfully diagnosed by computed tomography, and treated conservatively with antibiotics.