Radiologic Findings of Primary Epiploic Appendagitis: Focused on the Ultrasonographic Findings

PURPOSE: The purpose of this study was to analyze the radiologic findings of primary epiploic appendagitis, with particular attention to the correlation of ultrasonographic, clinical, CT, MR and surgical findings. MATERIALS AND METHODS: Among 14 patients with primary epiploic appendagitis who presented with the rapid onset of a very localized pain and tenderness, we performed ultrasonography in all, CT in eight, and MRI in four of these eight. Surgery was performed in two patients. Follow-up examinations were performed using US, CT and MRI (n=2), US and CT (n=2), US alone (n=2), and with regard to clinical features (n=12). RESULTS: US performed in 14 patients revealed the presence in all of small, well-defined, ovoid, noncompressible hyperechoic (n=12) or isoechoic (n=2) solid masses attached to the colonic wall, without bowel wall change and without communication with bowel lumen. CT performed in 8 patients showed varying hyperattenuating fatty lesions in the same location in the abdomen, without other inflammatory process. MRI findings of four patients were helpful for further evaluation of internal architecture. CONCLUSION: In primary epiploic appendagitis, US findings were sufficiently characteristic to allow accurate diagnosis and valuable for the differential diagnosis of other acute conditions of the abdomen.

Primary Epiploic Appendagitis: 4 Case Report

Primary epiploic appendagitis of the colon is a rare cause of abdominal pain and is a self-limiting disease. Double contrast barium enema showed a smooth extrinsic compression located anterolateraly to the involved colon. Ultrasonography revealed a non-compressible echogenic ovoid mass attached to the colon wall. On abdominal CT, all lesions were seen as pedunculated ovel fatty masses with surrounding streaky densities connected to the serosal surface of the adjacent colon. Follow up CT performed 13-25(mean 18) days later showed that during this intrval, the volume of the mass and extent of surrounding infiltrations had decreased.