Editor's quiz: GI snapshot
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From the question on page 10.1136/gut.2006.119248
The diagnosis was an inflamed epiploica. Acute left lower quadrant pain is frequently caused by diverticulitis, especially in elderly patients, but the most common differential diagnoses include renal colic, urinary tract infection, perforated carcinoma, epiploic appendagitis or other inflammatory diseases of the colon or, as in this case, epiploic appendagitis. Because the clinical impression may lead to a false diagnosis, imaging methods are necessary to establish a correct diagnosis. Sonography and CT are the imaging methods of choice for the examination of patients with left lower quadrant pain.
The US image of the left flank showed an oval non-compressible lesion with echogenic echotexture and peripheral hypoechoic rim. CT enteroclysis confirmed this, demonstrating a 3.5 cm long inflamed epiploic appendagitis seen as a fat density lesion with a surrounding hyperdense rim and inflammation abutting the distal descending colon.
Primary appendagitis epiploica is a rare benign
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Gut 2008 57: 567.[Extract] [Full Text] [PDF]
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