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

Risultato della ricerca: Article

2 Citazioni (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.
Lingua originaleEnglish
pagine (da-a)26-
Numero di pagine9
RivistaInsights into Imaging
Volume10
Stato di pubblicazionePublished - 2019

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Acute Pain
Abdominal Pain
Inflammation
Diverticulitis
Mesentery
Abdominal Cavity
Appendix
Appendicitis
Hernia
Veins
Hospitalization
Thrombosis
Fats
Anti-Bacterial Agents
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cita questo

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. Insights into Imaging, 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: Insights into Imaging, Vol. 10, 2019, pag. 26-.

Risultato della ricerca: Article

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', Insights into Imaging, vol. 10, pagg. 26-.
Galia M, Midiri M, Giambelluca D, Grassedonio E, Caruana G, Salvaggio G e altri. CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain. Insights into Imaging. 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: Insights into Imaging. 2019 ; Vol. 10. pagg. 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 - Galia, Massimo

AU - Midiri, Massimo

AU - Giambelluca, Dario

AU - Grassedonio, Emanuele

AU - Caruana, Giovanni

AU - Salvaggio, Giuseppe

AU - Salvaggio, Leonardo

AU - Cannella, Roberto

PY - 2019

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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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