Presentation
2 days right sided abdominal pain, no vomiting, diarrhea or fevers.
Patient Data
Focal circumscribed fat density lesion with internal linear hyperdensity and prominent surrounding fat stranding along the antimesenteric border of the ascending colon. The remainder of the large and small bowel are normal. The appendix is normal. No intra-abdominal free fluid or extraluminal gas. Hepatomegaly with diffusely reduced hepatic attenuation in keeping with steatosis. Small areas of focal fatty sparing. The gallbladder, adrenals, kidneys, pancreas and spleen are normal. The visualized lung bases show minor atelectasis but are otherwise clear. No aggressive osseous lesion.
Case Discussion
Ascending colon epiploic appendagitis.
This is a self limiting condition which may mimic other causes of abdominal pain such as diverticulitis or appendicitis. The ascending colon is a relatively uncommon site, with this condition being seen most commonly at the rectosigmoid region and ileocecal junction.
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