Torsion of the primary epiploic appendagitis: a case series and review of the literature

Ozdemir, Suleyman; Gulpinar, Kamil; Leventoglu, Sezai; Uslu, Hatim Yahya; Turkoz, Erdem; Ozcay, Necdet; Korkmaz, Atila

doi:10.1016/j.amjsurg.2009.02.004

« Previous Next »The American Journal of Surgery
Volume 199, Issue 4 , Pages 453-458, April 2010

Torsion of the primary epiploic appendagitis: a case series and review of the literature

Suleyman Ozdemir, M.D.
- Department of Surgery, Ufuk University, Medical School, Mevlana Bulvari 86-88 Mevlana, 06520, Ankara, Turkey
- Department of Surgery, Ankara Guven Hospital, Ankara, Turkey
- Corresponding author. Tel.: +0090-533-323-2502; fax: +0090-312-204-4055
Kamil Gulpinar, M.D.
- Department of Surgery, Ufuk University, Medical School, Mevlana Bulvari 86-88 Mevlana, 06520, Ankara, Turkey
- Department of Surgery, Ankara Guven Hospital, Ankara, Turkey
Sezai Leventoglu, M.D.
- Department of Surgery, Ankara Guven Hospital, Ankara, Turkey
Hatim Yahya Uslu, M.D.
- Department of Surgery, Ufuk University, Medical School, Mevlana Bulvari 86-88 Mevlana, 06520, Ankara, Turkey
Erdem Turkoz, M.D.
- Department of Surgery, Ankara Guven Hospital, Ankara, Turkey
Necdet Ozcay, M.D.
- Department of Surgery, Ankara Guven Hospital, Ankara, Turkey
Atila Korkmaz, M.D.
- Department of Surgery, Ufuk University, Medical School, Mevlana Bulvari 86-88 Mevlana, 06520, Ankara, Turkey

Received 17 January 2009; received in revised form 16 February 2009 published online 12 June 2009.

Abstract

Background

Differential diagnosis and appropriate treatment of epiploic appendagitis (EA) is a dilemma for general surgeons because of nonspecific signs and symptoms.

Methods

Twelve patients (3 women and 9 men, average age 40 years, range 18–82 years) who were diagnosed as having EA upon presenting to the emergency department or at the time of discharge between April 2002 and September 2008 were included.

Results

The major presenting symptom was abdominal pain. Physical examination revealed well-localized tenderness in all cases (n = 12); in addition, rebound tenderness and distention were also observed. Laboratory blood tests were normal except for 4 patients who had leukocytosis. Seven cases were diagnosed by an abdominal computed tomography scan. Five patients required surgical intervention, whereas the remaining did not.

Conclusions

Surgeons should be aware of this self-limiting disease that mimics many other intra-abdominal acute conditions. An abdominal computed tomography scan has a significant role in accurate diagnosis of EA before surgery to avoid unnecessary surgical interventions.

Keywords: Epiploic appendagitis, Torsion, Acute abdominal pain