Further imaging with an intravenous contrast enhanced CT scan of the abdomen showed a hyperdense rim lesion anteriorly, adjacent to the sigmoid colon in the left lower quadrant, along with inflammatory stranding that was consistent with epiploic appendagitis (EA) (Figure 1B).
Epiploic appendagitis mimics acute abdomen or is a condition associated with acute abdomen, although it is usually not treated by emergent surgical intervention and has characteristic findings on computed tomography (1).
However, several surgical and medical emergencies, including appendicitis, mesenteric lymphadenitis, epiploic appendagitis, and sclerosing mesenteritis may clinically resemble renal stone complaints.
The right gastric and right gastro epiploic artery was identified and ligated following which resection of the stricture with the pylorus was carried out.
Epiploic appendagitis is a relatively rare inflammatory condition of the fat-filled serosal outpouchings of the colon resulting from the obstruction of blood flow within the tissue [1, 2].
Several theories attempt to explain the underlying pathophysiology associated with this clinical entity including, mesenteric hypoperfusion, septic epiploic micro infarctions, splanchnic invasion via hematogenous spread or ascending infection from the urogenital tract, or immune complex deposition.
Fat stranding that is disproportionately more severe than the degree of wall thickening is a finding that suggests inflammatory diseases such as diverticulitis, appendicitis, or epiploic appendagitis.
The clinical differential diagnosis of acute abdominal pain depends on age and localization of the pain and includes acute pancreatitis, acute appendicitis, cholecystitis, gastroduodenal ulcer, diverticulitis, epiploic appendagitis, and other intra-abdominal inflammatory conditions.
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