- Torsion of epiploic appendages resultants in vascular occlusion that leads to ischemia: this has been implicated as the cause of acute epiploic appendagitis.
- The venous component of the appendage is affected first, because each appendage is supplied by paired arteries but drained by only one vein.
- Acute epiploic appendagitis is associated with obesity, hernia, and unaccustomed exercise.
- Inflammation of the epiploic appendages is self limited in the majority of patients. Rarely, acute epiploic appendagitis may result in adhesion, bowel obstruction, intussusception, peritonitis, and/or abscess formation.
- Condition most commonly manifests in the 4th to 5th decades of life, predominantly in men.
- Clinically, acute epiploic appendagitis manifests with acute onset of pain, most often in the left lower quadrant, and this symptom often leads to its being mistaken for acute diverticulitis.
- When acute epiploic appendagitis involves the cecum or ascending colon, it may be mistaken clinically for acute appendicitis.
- Most common sites of acute epiploic appendagitis, in order of decreasing frequency, are areas adjacent to the sigmoid colon, the descending colon, and the right hemicolon.
 Imaging Findings
- Most common CT feature in acute epiploic appendagitis is an oval lesion less than 5 cm in diameter (typical diameter range is 1.5–3.5 cm) that has attenuation equivalent to that of fat, abuts the anterior colonic wall, and is surrounded by inflammatory changes.
- The wall of the colon may be thickened but is most often normal in thickness.
- Although the presence of a central area of high attenuation due to venous thrombosis is useful for diagnosis, absence does not preclude a diagnosis of acute epiploic appendagitis.
Patient #1: CT demonstating epiploic appendagitis in a patient with right lower quadrant pain
Patient #2: CT demonstating epiploic appendagitis in a patient with right lower quadrant pain
 See Also
 External Links
- Ajay K. Singh, Debra A. Gervais, Peter F. Hahn, Pallavi Sagar, Peter R. Mueller, and Robert A. Novelline. Acute Epiploic Appendagitis and Its Mimics. RadioGraphics 2005 25: 1521-1534.