Presentation
Left iliac fossa pain for a few days. Tender and guarding on palpation. No nausea, vomiting, or constipation.
Patient Data
A small, well-defined fat density lesion measures about 16 mm at its maximum dimension, with an enhanced hyperattenuating ring sign surrounded by focal fat stranding noted at the antero-lateral aspect of the distal descending colon. There is no evidence of peri-colic collections or pneumoperitoneum.
Findings can be found with focal diverticulitis or epiploic appendagitis.
Sagittal reformate images were highly suggestive of epiploic appendagitis.
Sigmoid colon diverticulosis and fatty liver were noted.
Otherwise, normal.
The red arrow indicates an inflamed appendix epiploica of the descending colon with a hyperattenuating ring sign.
Case Discussion
Because of its placement in the left iliac fossa, epiploic appendagitis can mimic other diseases and induce acute abdominal pain. In this instance, it mimicked diverticulitis. Most instances receive conservative treatment. Intraperitoneal focal fat infarction encompasses additional conditions, such as omental infarction, and epiploic appendagitis is one of them.
In our case, the patient represented the rarest location for epiploic appendagitis, which is the descending colon, received conservative treatment, and was completely resolved.
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