Case report: Pericolic abscess secondary to torsion of an appendix epiploica

Romaniuk, C. S.; Simpkins, K.C.

doi:10.1016/s0009-9260(05)81169-9

Cited by 29 publications

(22 citation statements)

References 7 publications

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“…Torsion and infarction are more common in obese patients where the epiploicae are bulky, and are usually found in the sigmoid colon where the epiploicae are longest. 2,3 Only one of our patients had the epiploic appendix torsion and infarction in the sigmoid colon.…”

Section: Discussionmentioning

confidence: 84%

“…Complications related to the epiploic appendices include diverticulitis, intestinal obstruction secondary to adherence to small bowel, and torsion and infarction. [1][2][3] Only torsion and infarction were seen in four of our patients. Torsion and infarction are more common in obese patients where the epiploicae are bulky, and are usually found in the sigmoid colon where the epiploicae are longest.…”

Section: Discussionmentioning

confidence: 99%

“…Local abscess formation may occur, simulating a neoplastic process. 2 Calcified peritoneal loose bodies found during laparotomy are thought to be remnants resulting from spontaneous resolution of torsion. 7 Epiploic appendagitis may show a stricture on barium enema because of extrinsic compression simulating carcinoma.…”

Section: Discussionmentioning

confidence: 99%

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Torsion of Abdominal Appendages Presenting with Acute Abdominal Pain

2000

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Background: Diseases of the abdominal appendages are rare causes of abdominal pain in all age groups. Patients and Methods: Nine patients with torsion and infarction of abdominal appendages were retrospectively reviewed. Results: Four patients had torsion and infarction of the appendices epiploicae, four patients had torsion and infarction of part of the greater omentum, and one patient had torsion and infarction of the falciform ligament. The patient with the falciform ligament disease represents the first reported case of primary torsion and infarction of the falciform ligament, and the patient with the transverse colon epiploica represents the first reported case of vibrationinduced appendix epiploica torsion and infarction. The patient with the falciform ligament disease presented with a tender upper abdominal mass, and the remaining patients were operated upon with the preoperative diagnosis of acute appendicitis. Conclusion:The presence of normal appendix with free serosanguinous fluid in the peritoneal cavity should raise the possibility of a disease, and calls for further evaluation of the intra-abdominal organs. If the diagnosis is suspected preoperatively, CT scan and ultrasound may lead to a correct diagnosis and possibly conservative management: Laparoscopy is playing an increasing diagnostic and therapeutic role in such situations.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Torsion of Abdominal Appendages Presenting with Acute Abdominal Pain

2000

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“…Patients should be counseled to return for surgical excision of the affected appendage if their symptoms persist, as this is considered the only definitive cure (Apakama et al, 2011;Rioux et al, 1994;Schwartz et al, 1994). Although rare, adverse outcomes of expectantly managed PEA have been reported and include abscess formation, bowel obstruction, intussusception, peritonitis and death (Romaniuk et al, 1993;Shamblin et al, 1986;Puppala et al, 1981;Murdie, 1953;Ghahremani, 1992;Apakama, 2011). Our patient presented with characteristic symptoms of PEA: a sharp, well-localized non-migratory pain in the left lower quadrant without additional gastrointestinal symptoms.…”

Section: Discussionmentioning

confidence: 99%

An Uncommon Cause of Acute Abdominal Pain: Primary Epiploic Appendagitis in the Emergency Setting

Casey¹,

DiVito²,

Lupow³

et al. 2017

EJBM

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In the emergency setting, the diagnosis of benign causes of acute abdominal pain can prevent unnecessary medical interventions. To illustrate this point, we report the case of a 28-year-old man who presented to the emer- gency department with symptoms suggestive of acute diverticulitis. Abdominal computed tomography (CT) established, instead, a diagnosis of primary epiploic appendagitis (PEA), which was managed expectantly. The patient’s symptoms resolved within one week of hospital discharge and he remained free of pain at a five-month phone follow-up. Increased awareness of PEA and its self-limited course can help the emergency physician avoid unnecessary imaging studies and expectantly manage this cause of acute abdominal pain.

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“…2 Antibiotics are generally not indicated 3 , except in rare cases in which colonic bacteria infiltrate and cause localized abscess formation or generalized peritonitis. 4 Surgical intervention is only necessary in the uncommon event of secondary complications such as bowel obstruction. 5 Symptoms generally self-resolve within a week.…”

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confidence: 99%