[Epiploic appendagitis: sonographic findings in 28 cases].

AIM: To investigate the sonographic signs of epiploic appendagitis in a larger number of patients and to add new details. PATIENTS AND METHODS: Over a period of approximately 8 years 28 patients were sonographically diagnosed to have epiploic appendagitis. The following sonographic signs were investigated: echogenicity of the lesion; compressibility; shape of the lesion; adherence to the anterior abdominal wall; peripheral rim; central hypoechoic line; thickening of the colonic wall. In 11 of these patients colour Doppler sonography was performed. In addition all 28 patients underwent CT.
RESULTS: In 28/28 cases (100 %) a moderately hyperechoic, ovoid, non-compressible mass adjacent to the colon was demonstrated. The mass was surrounded by a hypoechoic rim in 20 cases (71 %) and was fixed to the abdominal wall in 26/28 cases (93 %). Five cases (18 %) revealed a central hypoechoic line, and slight thickening of the colonic wall was visible in 2 cases (7 %). In those cases where colour Doppler sonography was performed, colour flow was absent in the central part of the lesion. In the peripheral zone slightly increased colour flow was demonstrable in 9/11 cases.
CONCLUSION: Epiploic appendagitis has a characteristic sonographic appearance with a moderately hyperechoic, ovoid, non-compressible lesion adjacent to the colon and adherent to the abdominal wall. The mass is frequently surrounded by a hypoechoic rim. Colour Doppler sonography shows a central avascular area and slightly increased colour flow in the peripheral zone.