Literature DB >> 24187459

Differential diagnosis of left-sided abdominal pain: primary epiploic appendagitis vs colonic diverticulitis.

Jeong Ah Hwang1, Sun Moon Kim, Hyun Jung Song, Yu Mi Lee, Kyung Min Moon, Chang Gi Moon, Hoon Sup Koo, Kyung Ho Song, Yong Seok Kim, Tae Hee Lee, Kyu Chan Huh, Young Woo Choi, Young Woo Kang, Woo Suk Chung.   

Abstract

AIM: To investigate the clinical characteristics of left primary epiploic appendagitis and to compare them with those of left colonic diverticulitis.
METHODS: We retrospectively reviewed the clinical records and radiologic images of the patients who presented with left-sided acute abdominal pain and had computer tomography (CT) performed at the time of presentation showing radiological signs of left primary epiploic appendagitis (PEA) or left acute colonic diverticulitis (ACD) between January 2001 and December 2011. A total of 53 consecutive patients were enrolled and evaluated. We also compared the clinical characteristics, laboratory findings, treatments, and clinical results of left PEA with those of left ACD.
RESULTS: Twenty-eight patients and twenty-five patients were diagnosed with symptomatic left PEA and ACD, respectively. The patients with left PEA had focal abdominal tenderness on the left lower quadrant (82.1%). On CT examination, most (89.3%) of the patients with left PEA were found to have an oval fatty mass with a hyperattenuated ring sign. In cases of left ACD, the patients presented with a more diffuse abdominal tenderness throughout the left side (52.0% vs 14.3%; P = 0.003). The patients with left ACD had fever and rebound tenderness more often than those with left PEA (40.0% vs 7.1%, P = 0.004; 52.0% vs 14.3%, P = 0.003, respectively). Laboratory abnormalities such as leukocytosis were also more frequently observed in left ACD (52.0% vs 15.4%, P = 0.006).
CONCLUSION: If patients have left-sided localized abdominal pain without associated symptoms or laboratory abnormalities, clinicians should suspect the diagnosis of PEA and consider a CT scan.

Entities:  

Keywords:  Acute abdomen; Appendix epiploica; Colonic diverticulitis; Differential diagnosis; Multidetector computed tomography

Mesh:

Year:  2013        PMID: 24187459      PMCID: PMC3812483          DOI: 10.3748/wjg.v19.i40.6842

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


  26 in total

1.  CT evaluation of the colon: inflammatory disease.

Authors:  K M Horton; F M Corl; E K Fishman
Journal:  Radiographics       Date:  2000 Mar-Apr       Impact factor: 5.333

2.  Acute appendagitis: emergency presentation and computed tomographic appearances.

Authors:  R Subramaniam
Journal:  Emerg Med J       Date:  2006-10       Impact factor: 2.740

3.  Case 6: primary epiploic appendagitis.

Authors:  P M Rao; R A Novelline
Journal:  Radiology       Date:  1999-01       Impact factor: 11.105

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Authors:  L B Ferzoco; V Raptopoulos; W Silen
Journal:  N Engl J Med       Date:  1998-05-21       Impact factor: 91.245

5.  Epiploic appendagitis: adding to the differential of acute abdominal pain.

Authors:  E L Legome; C Sims; P M Rao
Journal:  J Emerg Med       Date:  1999 Sep-Oct       Impact factor: 1.484

Review 6.  Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review.

Authors:  D R Vinson
Journal:  J Emerg Med       Date:  1999 Sep-Oct       Impact factor: 1.484

7.  Infarction of the appendices epiploicae.

Authors:  J J Shehan; C Organ; J F Sullivan
Journal:  Am J Gastroenterol       Date:  1966-12       Impact factor: 10.864

8.  Primary epiploic appendagitis: evolutionary changes in CT appearance.

Authors:  P M Rao; J Wittenberg; J N Lawrason
Journal:  Radiology       Date:  1997-09       Impact factor: 11.105

Review 9.  Radiological features of epiploic appendagitis and segmental omental infarction.

Authors:  M J McClure; K Khalili; J Sarrazin; A Hanbidge
Journal:  Clin Radiol       Date:  2001-10       Impact factor: 2.350

10.  Epiploic disorders. Conditions of the epiploic appendages.

Authors:  D H Carmichael; C H Organ
Journal:  Arch Surg       Date:  1985-10
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  10 in total

1.  The Diagnostic Dilemma of Primary Epiploic Appendagitis and How to Establish a Diagnosis.

Authors:  Stavros Gourgiotis; Christianna Oikonomou; George Veloudis; Ioanna Lardou; George Pittaras; Constantinos Villias
Journal:  Oman Med J       Date:  2016-05

2.  Know the name: acute epiploic appendagitis-CT findings and review of literature.

Authors:  Hina Patel; Ahmed Abdelbaki; Peter Steenbergen; Charu Chanana; Shuo Li
Journal:  AME Case Rep       Date:  2018-03-07

3.  Recurrent epiploic appendagitis and peritoneal dialysis: A case report and literature review.

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Journal:  World J Nephrol       Date:  2014-08-06

4.  Epiploic Appendagitis as a Rare Cause of Acute Abdomen in the Pediatric Population: Report of Three Cases.

Authors:  Mesut Ozturk; Serdar Aslan; Dilek Saglam; Tumay Bekci; Meltem Ceyhan Bilgici
Journal:  Eurasian J Med       Date:  2018-02-01

5.  Dissimilar Pain of Primary Epiploic Appendagitis and Malabsorption.

Authors:  Wolfgang J Schnedl; Dietmar Enko; Sandra J Wallner-Liebmann; Sonja Lackner; Harald Mangge
Journal:  J Clin Diagn Res       Date:  2017-02-01

6.  Primary epiploic appendagitis: reconciling CT and clinical challenges.

Authors:  Jamel Saad; Hussein Ali Mustafa; Asem Mohamed Elsani; Fawaz Alharbi; Saad Alghamdi
Journal:  Indian J Gastroenterol       Date:  2014-06-18

7.  Co-occurrence of carbohydrate malabsorption and primary epiploic appendagitis.

Authors:  Wolfgang J Schnedl; Peter Kalmar; Harald Mangge; Robert Krause; Sandra J Wallner-Liebmann
Journal:  World J Gastroenterol       Date:  2015-09-21       Impact factor: 5.742

8.  An unusual cause of acute abdomen-epiploic appendicitis: report of two cases.

Authors:  Busra Burcu; Ozgur Ekinci; Ibrahim Inan; Ferman Tevfik Ozyalvac; Turgut Tunc Eren; Orhan Alimoglu
Journal:  North Clin Istanb       Date:  2015-09-25

Review 9.  CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain.

Authors:  Dario Giambelluca; Roberto Cannella; Giovanni Caruana; Leonardo Salvaggio; Emanuele Grassedonio; Massimo Galia; Massimo Midiri; Giuseppe Salvaggio
Journal:  Insights Imaging       Date:  2019-02-22

10.  Primary epiploic appendagitis: compared with diverticulitis and focused on obesity and recurrence.

Authors:  Youn I Choi; Hyun Sun Woo; Jun-Won Chung; Young Sup Shim; Kwang An Kwon; Kyoung Oh Kim; Yoon Jae Kim; Dong Kyun Park
Journal:  Intest Res       Date:  2019-10-14
  10 in total

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