Epiploic appendagitis: color Doppler sonographic findings

Abstract

The aim of this study was to analyze the color Doppler sonographic findings in primary epiploic appendagitis. Color Doppler sonographic findings of ten patients with primary epiploic appendagitis were reviewed. The following sonographic features were analyzed: identification of a mass adjacent to the colonic wall; identification of spotty color areas with arterial flow in this mass and detection of abnormalities of the colonic wall adjacent to the infiltrated fatty tissue. A well-delineated hyperechoic mass adjacent to the colonic wall was detected in each patient with sonography. No colonic wall abnormalities were observed nor color Doppler signal in and around the hyperechoic area. Absence of flow at color Doppler sonography is an additional feature of epiploic appendagitis.

Contrast-enhanced ultrasound appearance of primary epiploic appendagitis

“…Specific clinical features and grey-scale sonography findings of PEA are lacking; furthermore, there is the absence of flow in colour Doppler imaging [8,9]. In this single patient, CEUS has confirmed that a thick rim of enhancement and a hypoechoic central area of the mass are characteristic features of PEA, as was previously reported by Görg [6].…”

Primary epiploic appendagitis: Sonographic findings with CT correlation

“…In contrast, pronounced arterial flow can be observed in cases with inflammatory infiltration of epiploic appendages secondary to diverticulitis or other inflammatory conditions. 18 In our experience, however, there are slight to moderate color signals, indicating blood flow around the ischemic lesion. The hyperechoic infarcted appendage may be surrounded by a hypoechoic rim owing to the thickened serosal surface of the necrotic tissue.…”

“…1,3,14 Some authors report that it occurs with equal frequency in men and women, 2,3 but others report a predominance in men (Table 1). 14,17,18 …”

“…3,18,23 None of these studies have revealed color Doppler signals in or even around the hyperechoic mass. In contrast, pronounced arterial flow can be observed in cases with inflammatory infiltration of epiploic appendages secondary to diverticulitis or other inflammatory conditions.…”

“…22 Color Doppler sonography in these cases shows increased blood flow in the bowel wall and in the area of peridiverticular inflammation. 18 Diverticulosis may also be present in epiploic appendagitis, especially in elderly patients, but typical signs of diverticulitis are absent 22 ( Figures 6 and 7). …”