Torsion of appendices epiploicae masquerading as ogilve’s syndrome.

ABSTRACT

Torsion of appendices ep loicae is an uncommon differential diagnosis of a patient presenting with acute abdominal pain and its presentation as a Ogilvie’s syndrome or colonic ileus is even rare.The diagnosis requires a keen suspicion on the part of the attending surgeon. Preoperative computrized tomography ( CT) may help in the diagnosis but the final diagnosis is established only on the operating table . Adding this pathology to the existing list of the causes of colonic ileus /Ogilvies syndrome may give us a good insight into the understanding of the condition&improvise our management. This is a case report of 60 year old lady who was referred to us with nonspecific abdominal pain , distention of abdomen and vomiting from orthopaedics department , where she was being planned for surgery for intertrochanteric fracture femur. All our investigations were equivocal and suggested a Ogilvie’s syndrome like picture .Atrial of neostigmine therapy was also given after excluding physical obstruction and the patient did not respond and the patient was operated upon and intraoperative finding of torsed epiploic appendage was found as the cause of her symptoms. The patient made a good post operative recovery following surgical excision of torsed epiploic appendages. This case should give us another dimension of thought in the management of such cases and help improvise our management.