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We present a case of a 72 year old male patient, who presented to the emergency department with a 2 day history of right iliac fossa pain. On examination he was apyrexial and haemodynamically stable, yet displayed signs of right iliac fossa peritonism. Inflammatory markers were mildly raised. Computed tomography and diagnostic laparoscopy both demonstrated typical features of epiploic appendagitis. Epiploic appendagitis is an uncommon cause of the acute abdomen, yet is probably underdiagnosed. The term was first used by Lynn et al. in the mid 1950s. With the increase in CT scanning and diagnostic laparoscopy, we feel that both surgeons and radiologists need to be increasingly aware of the clinical and radiological appearances of epiploic appendagitis.

Appendicectomy is one of the commonest emergency operations performed worldwide. In cases of perforated appendicitis, the prevalence of post-operative abscess formation is up to 20 per cent (1). Most cases can be managed with drainage and antibiotics. However, a minority of these will leave a retained appendicolith.We present a case of a 17 year old female patient who presented 1 year after laparoscopic appendicectomy for perforated appendicitis, with right upper quadrant pain and sepsis.Computed tomography (CT) of the abdomen was performed and revealed a retained appendicolith with perihepatic abscess formation in the right upper quadrant. She underwent laparoscopic drainage of this perihepatic abscess and removal of the faecolith. She was discharged home the following day and remains well.

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