Summary
Introduction. Epiploic appendagitis is a rare and often misdiagnosed cause of acute abdominal pain. It can be primary or secondary. Epiploic appendagitis often mimics other acute abdominal conditions, such as appendicitis or diverticulitis, which typically require surgical intervention. Imaging techniques play a crucial role in accurately identifying epiploic appendagitis, differentiating it from more common pathologies, and preventing misdiagnosis. A precise diagnosis is essential for selecting the appropriate treatment strategy for patients.
Objective. This review aims to highlight the diagnostic challenges of epiploic appendagitis and emphasize the role of imaging, particularly CT and ultrasound, in differentiating it from other causes of abdominal pain.
Methods. A narrative literature review was conducted. Data and information were collected from the PubMed and Google Scholar databases using the following keywords: epiploic appendagitis, abdominal pain, acute abdomen, differential diagnosis, diverticulitis, omental infarction, mesenteric panniculitis, and appendicitis. A total of 28 articles were selected that met the study objectives.
Conclusions. CT imaging is the gold standard for diagnosing epiploic appendagitis, but ultrasound also provides important information. Differential diagnosis of epiploic appendagitis most often include the deseases, that show plenty fat stranding with minimal bowel wall thickening. These deseases are: diverticulitis, appendicitis omental infarction and mesenteric panniculitis. Key CT features, that are very important in differentiation, include an ovoid fat-density lesion with a hyperattenuating ring and central dot sign, while ultrasound shows a hyperechoic, non-compressible oval mass circumscribed by a hypoechoic line with the absence of bowel wall involvement and absence of signal on color Doppler imaging.
