CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain

Massimo Galia, Massimo Midiri, Dario Giambelluca, Emanuele Grassedonio, Giovanni Caruana, Giuseppe Salvaggio, Leonardo Salvaggio, Roberto Cannella

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Epiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation surrounded by a thin hyperdense rim on CT (“hyperattenuating ring sign”) abutting anteriorly the large bowel, usually associated with inflammation of the adjacent mesentery. A central high-attenuation focus within the fatty lesion (“central dot sign”) can sometimes be observed and is indicative of a central thrombosed vein within the inflamed epiploic appendage. Rarely, epiploic appendagitis may be located within a hernia sac or attached to the vermiform appendix. Chronically infarcted epiploic appendage may detach, appearing as an intraperitoneal loose calcified body in the abdominal cavity. In this review, we aim to provide an overview of the clinical presentation and key imaging features that may help the radiologist to make an accurate diagnosis and guide the clinical management of those patients.
Original languageEnglish
Pages (from-to)26-
Number of pages9
JournalDefault journal
Volume10
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Galia, M., Midiri, M., Giambelluca, D., Grassedonio, E., Caruana, G., Salvaggio, G., ... Cannella, R. (2019). CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. Default journal, 10, 26-.

CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. / Galia, Massimo; Midiri, Massimo; Giambelluca, Dario; Grassedonio, Emanuele; Caruana, Giovanni; Salvaggio, Giuseppe; Salvaggio, Leonardo; Cannella, Roberto.

In: Default journal, Vol. 10, 2019, p. 26-.

Research output: Contribution to journalArticle

Galia, M, Midiri, M, Giambelluca, D, Grassedonio, E, Caruana, G, Salvaggio, G, Salvaggio, L & Cannella, R 2019, 'CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain', Default journal, vol. 10, pp. 26-.
Galia M, Midiri M, Giambelluca D, Grassedonio E, Caruana G, Salvaggio G et al. CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. Default journal. 2019;10:26-.
Galia, Massimo ; Midiri, Massimo ; Giambelluca, Dario ; Grassedonio, Emanuele ; Caruana, Giovanni ; Salvaggio, Giuseppe ; Salvaggio, Leonardo ; Cannella, Roberto. / CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. In: Default journal. 2019 ; Vol. 10. pp. 26-.
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abstract = "Epiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation surrounded by a thin hyperdense rim on CT (“hyperattenuating ring sign”) abutting anteriorly the large bowel, usually associated with inflammation of the adjacent mesentery. A central high-attenuation focus within the fatty lesion (“central dot sign”) can sometimes be observed and is indicative of a central thrombosed vein within the inflamed epiploic appendage. Rarely, epiploic appendagitis may be located within a hernia sac or attached to the vermiform appendix. Chronically infarcted epiploic appendage may detach, appearing as an intraperitoneal loose calcified body in the abdominal cavity. In this review, we aim to provide an overview of the clinical presentation and key imaging features that may help the radiologist to make an accurate diagnosis and guide the clinical management of those patients.",
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AU - Midiri, Massimo

AU - Giambelluca, Dario

AU - Grassedonio, Emanuele

AU - Caruana, Giovanni

AU - Salvaggio, Giuseppe

AU - Salvaggio, Leonardo

AU - Cannella, Roberto

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N2 - Epiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation surrounded by a thin hyperdense rim on CT (“hyperattenuating ring sign”) abutting anteriorly the large bowel, usually associated with inflammation of the adjacent mesentery. A central high-attenuation focus within the fatty lesion (“central dot sign”) can sometimes be observed and is indicative of a central thrombosed vein within the inflamed epiploic appendage. Rarely, epiploic appendagitis may be located within a hernia sac or attached to the vermiform appendix. Chronically infarcted epiploic appendage may detach, appearing as an intraperitoneal loose calcified body in the abdominal cavity. In this review, we aim to provide an overview of the clinical presentation and key imaging features that may help the radiologist to make an accurate diagnosis and guide the clinical management of those patients.

AB - Epiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation surrounded by a thin hyperdense rim on CT (“hyperattenuating ring sign”) abutting anteriorly the large bowel, usually associated with inflammation of the adjacent mesentery. A central high-attenuation focus within the fatty lesion (“central dot sign”) can sometimes be observed and is indicative of a central thrombosed vein within the inflamed epiploic appendage. Rarely, epiploic appendagitis may be located within a hernia sac or attached to the vermiform appendix. Chronically infarcted epiploic appendage may detach, appearing as an intraperitoneal loose calcified body in the abdominal cavity. In this review, we aim to provide an overview of the clinical presentation and key imaging features that may help the radiologist to make an accurate diagnosis and guide the clinical management of those patients.

KW - Abdominal pain; Acute abdomen; Adipose tissue; Differential diagnosis; Epiploic appendices; Large intestine; Radiology

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