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Papers of the Week

2021 Dec




Epiploic Appendagitis Clinically Masquerading as an Acute Diverticulitis.


Khafaji RA, Ghandourah HS, Altamimi SK, Alwarthan AA, Alhabib RA, Alaiyar MN, Alomar IA, Alayshan MI, Almasoudi MS, Jaml Allil HA, Munshi SZ, Aljamri SK, Bagadeem BS, Attar MS, Al-Hawaj F
Cureus. 2021 Dec; 13(12):e20188.
PMID: 35004011.


Acute diverticulitis is a prevalent surgical condition that typically presents with lower abdominal pain and tenderness. However, the clinical and laboratory findings of diverticulitis are non-specific and other conditions may give similar manifestations. We present the case of a middle-aged woman with a left lower quadrant abdominal pain and fever of three days duration. On examination, she had tachycardia and localized tenderness in the left iliac fossa with rebound tenderness. There were no signs of peritonitis, including the rigid abdomen and decreased bowel sounds. The laboratory findings were suggestive of an inflammatory or infectious process. A computed tomography scan of the abdomen demonstrated a fat-density lesion anterior to the descending colon representing epiploic appendagitis. The patient was managed conservatively with non-steroidal anti-inflammatory drugs (lornoxicam 8 mg). The patient experienced gradual improvement and was discharged after four days of hospitalization. No surgical intervention was needed. The case highlighted the importance of considering epiploic appendagitis in the differential diagnosis of acute diverticulitis. An accurate diagnosis will prevent the patient from having unnecessary surgeries as conservative management is often sufficient in patients with epiploic appendagitis.