Primary Torsion and Infarction of the Appendices Epiploicae

Pines, Bernard; Rabinovitch, Jacob; Biller, Samuel B.

doi:10.1001/archsurg.1941.01210100135012

Cited by 59 publications

(32 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Epiploic appendagitis is a rare inflammatory and ischemic condition that results from torsion or spontaneous venous thrombosis of one of the appendices epiploicae (14). The result is ischemia or infarction of the appendix epiploica and localized inflammation.…”

Section: Epiploic Appendagitismentioning

confidence: 99%

CT Evaluation of the Colon: Inflammatory Disease

Horton¹,

Corl²,

Fishman³

2000

RadioGraphics

394

186

View full text Add to dashboard Cite

Computed tomography (CT) is valuable for detection and characterization of many inflammatory conditions of the colon. At CT, a dilated, thickened appendix is suggestive of appendicitis. A 1-4-cm, oval, fatty pericolic lesion with surrounding mesenteric inflammation is diagnostic of epiploic appendagitis. The key to distinguishing diverticulitis from other inflammatory conditions of the colon is the presence of diverticula in the involved segment. In typhlitis, CT demonstrates cecal distention and circumferential thickening of the cecal wall, which may have low attenuation secondary to edema. In radiation colitis, the clinical history is the key to suggesting the diagnosis because the CT findings can be nonspecific. The location of the involved segment and the extent and appearance of wall thickening may help distinguish Crohn disease and ulcerative colitis. In ischemic colitis, CT typically demonstrates circumferential, symmetric wall thickening with fold enlargement. CT findings of graft-versus-host disease include small bowel and colonic wall thickening, which may result in luminal narrowing and separation of bowel loops. In infectious colitis, the site and thickness of colon affected may suggest a specific organism. The amount of wall thickening in pseudomembranous colitis is typically greater than in any other inflammatory disease of the colon except Crohn disease.

show abstract

Section: Epiploic Appendagitismentioning

confidence: 99%

CT Evaluation of the Colon: Inflammatory Disease

Horton¹,

Corl²,

Fishman³

2000

RadioGraphics

394

186

View full text Add to dashboard Cite

show abstract

“…These fi nger-like projections are enveloped by a serosal layer and are supplied by one or two small end arteries from the colonic vasa recta and drained by a tortuous vein through a narrow pedicle. 2,3 The embryologic development of epiploic appendages begins in the second trimester of fetal life 4 and they attain an average length of 3 cm (0.5-5.0 cm) and a thickness of 1-2 cm by adulthood, although they occasionally grow to as long as 15 cm. 5 Over 100 epiploic appendages span the entire colon, most of which are in the cecum and sigmoid colon.…”

Section: Discussionmentioning

confidence: 99%

Epiploic Appendagitis: Report of Two Cases

et al. 2007

View full text Add to dashboard Cite

Epiploic appendagitis (EA) refers to primary or secondary inflammatory disease of the epiploic appendages: peritoneal pouches of subserosal fat, which run in parallel rows beside the taenia coli of the colon. It is an uncommon but self-limiting condition, which often mimics acute appendicitis or diverticulitis. An accurate diagnosis of EA can be made by performing an abdominal computed tomography scan. Establishing a correct preoperative diagnosis is important to avoid unnecessary exploratory laparoscopy or laparotomy. We report two cases of EA, which to our knowledge represent the first documented cases from India.

show abstract

“…6 The function of the appendages is not exactly known but is proposed to be similar to the greater omentum as a form of protection; they also may act as cushioning during peristalsis. 8 Each epiploic appendage encloses a small end artery branching from the vasa recta of the colon, and a draining vein that passes through its narrow pedicle. Its limited blood supply, pedunculated shape, and excessive mobility make it prone to torsion, ischemia, or hemorrhagic infarction.…”

Section: Question: What Is Epiploic Appendagitis and Its Pathophysiolmentioning

confidence: 99%

It’s Not Appendicitis...? Consideration of a Benign Mimicker

Joshi¹,

Fleming²,

Spottswood

2015

Hospital Pediatrics

View full text Add to dashboard Cite

Case: A previously healthy 16-year-old boy with a normal BMI presented to the emergency department with a 4-day history of severe, colicky pain in his right lower abdomen and right lower back. Before admission, while working as a cook in a restaurant, the patient reported twisting his torso and experiencing a stabbing pain on the right side of his abdomen that wrapped around to his right fl ank. The pain was so severe that he was taken by ambulance to a regional hospital. At the hospital, appendicitis was suspected, so an abdominal computed tomography (CT) scan was performed. The normal scan ruled out appendicitis and the patient was discharged with ibuprofen. However, the pain continued to worsen. Four days later, the patient arrived at this institution's pediatric emergency department and described his pain as intermittently stabbing with movement and dull and throbbing during rest. The patient reported persistent nausea and pain when bearing down but not during defecation. He had normal bowel movements with no constipation or blood, normal urine output without blood or dysuria, and reported tactile fevers. He reported no other illnesses or symptoms before or since the onset of the pain. After re-review of the original CT showing possible early changes consistent with appendicitis and persisting peritoneal signs on examination, the attending physician requested repeat abdominal CT. Question: What is appropriate imaging for evaluation of appendicitis?Per our institution's radiology protocol, ultrasound is the preferred screen for appendicitis; however, if the referring physician has a high suspicion after an equivocal study, a follow-up CT may be performed. As promoted by the Image Gently Campaign, and supported by current literature, reducing the number of abdominal/pelvic CT scans by 33% can lead to a proportionate decrease in pediatric cancers.1 Thus, ideally, ultrasound should be the fi rst imaging method used. 2,3Case Continuation: The repeat CT was read as normal by an on-call radiology fellow. The child's laboratories revealed a normal white blood cell (WBC) count 9000/µL, hematocrit 46 000/µL, erythrocyte sedimentation rate 4 mm/h, C-reactive protein 0.2 mg/L, creatinine kinase 56 IU/L, and negative porphyrins. His complete metabolic panel was normal except for mildly elevated glucose of 120 mg/dL and total bilirubin level at 1.6 mg/dL. Urinalysis was normal. The patient had decreased appetite and fl uid intake, so he was started on intravenous fl uids. He was given intravenous morphine and ondansetron for pain control and worsening nausea. Physical examination of the patient's abdomen was negative for Rovsing, Obturator, and Psoas signs positive for pain with movement, such as positional

show abstract

Primary Torsion and Infarction of the Appendices Epiploicae

Cited by 59 publications

References 2 publications

CT Evaluation of the Colon: Inflammatory Disease

CT Evaluation of the Colon: Inflammatory Disease

Epiploic Appendagitis: Report of Two Cases

It’s Not Appendicitis...? Consideration of a Benign Mimicker

Contact Info

Product

Resources

About