Is Outpatient Follow-Up of Epiploic Appendagitis with NSAIDs Alone and Noantibiotics Possible?

Abstract

Purpose: To assess the clinical course of patients diagnosed as having "epiploic appendagitis" who are given only NSAIDs without antibiotic treatment. Materials and Methods: Between December 2010 and November 2013, twelve patients were presented to the Emergency Surgery Department, Istanbul Medical Faculty, Istanbul University with abdominal pain and were diagnosed having "epiploic appendagitis". The diagnoses were made using the information gathered from patients' complaints, physical examination, biochemical results, and radiologic images (Abdominal X-Ray, Abdominal Ultrasonography [USG], and Contrast-Enhanced Computerized Tomography [CT]). We evaluated and recorded the patients' age distribution, sex difference, laboratory results, radiologic images, length of hospital stay, and control exams after discharge. Results: Twelve out of 35,574 (0.033%) patients who were presented to our Emergency Surgery Department with abdominal pain and were hospitalized as "epiploic appendagitis". Of these 12 patients, 7 were male (58.3%), and 5 were female (41.7%). The mean age of the patients was 43.5 (range: 22 to 60). The mean time passed between the beginning of the symptoms and presentation to the hospital was 1 day. The length of hospital stay was 1 to 2 days with a mean of 1.3 days. All patients were followed-up non-invasively under NSAID treatment without antibiotherapy. No complications were observed throughout the hospitalization period. The follow-up period of the patients was between 2 to 31 months with a mean of 16 months. Conclusion: Epiploic appendagitis is a self-limiting, benign disease, but differential diagnosis should be done carefully. Patients who are diagnosed with epiploic appendagitis may be followed-up with NSAIDs alone without hospitalization or antibiotherapy.