Brief clinical review CT findings in epiploic appendagitis

Appendix epiploicae are normal, fat-filled outpouchings of peritoneum arising from the serosal surface of the colon. They occur anywhere from the cecum to the rectosigmoid junction. They vary in size up to 5-cm in length and 2-cm in width. In the normal abdomen, they are indistinguishable by computerized tomography (CT) from other pericolic fat in the mesocolon, omentum, or retroperitoneum. Appendix epiploicae are nourished by the branches of arteria colica. Because of the weak blood flow and their free movement ability due to their pedinculated formation, they can be exposed to torsion and infarction easily. Epiploic appendagitis (EA) is an unusual cause of acute abdomen, which is usually the consequence of torsion and infarction of the appendix epiploicae. It mimics other inflammatory entities such as appendicitis and diverticulitis. EA can be easily misdiagnosed and incorrect treatment can be applied. The treatment of EA is generally symptomatic. The increasing use of emergency abdominal CT scan helps in the correct diagnosis of EA and the differentiation of this inflammatory disease from its similar counterparts, which require antibiotics and surgical treatment. This study describes the CT findings of EA and emphasizes the importance of differential diagnosis, including appendicitis and diverticulitis, to avoid unnecessary surgery.