Objectives Our aim was to explain the spectrum of clinical
and CT findings in 18 patients with acute epiploic
appendagitis.
Methods and Materials We reviewed the clinical records and
CT pictures of 18 consecutive patients seen in Nejran Armed
Forces Hospital, Nejran, Kingdom of Saudi Arabia and Sohag
University Hospital, Sohag, Egypt between July 2006 and
June 2013 with a diagnosis of primary epiploic appendagitis.
Results The age ranged between 22 and 64 years old with a
mean of 44.3. Males were affected in 72 % of cases. Eleven
patients had acute pain in left lower quadrant. Nausea and
vomiting were encountered in four patients. No fever was
recorded in all cases. Leukocytosis was found in four patients
and C-reactive protein (CRP) was high in five. CT scan
diagnosed primary epiploic appendagitis (PEA) in 15 patients,
while 3 patients were diagnosed intraoperatively. The left
colon was affected in 11 patients. All patients except one
had a central fatty core surrounded by inflammation with size
ranging between 1.5 and 3.5 cm in length. Fifteen patients
were treated conservatively, and three cases underwent surgical
exploration. Ten patients (55.5%) completed the follow up
schedule. Complete resolution was noted in three patients at
2 weeks, in six patients at 3 months, and only one patient had
residual changes at 6 months.
Conclusion PEA is a challenging clinical diagnosis, and CT
scan is extremely necessary in diagnosing this disease accurately.
The awareness of the surgeons concerning this rare
occasion will avoid unnecessary hospital admission and operative
treatment.