A rare cause of acute abdomen: Epiploic appendagitis

Abstract

Primary epiploic appendagitis brings together torsions and primary inflammations of epiploic appendices. These pathological events are rare and, for a long period of time, have been exceptionally diagnosed in preoperative period. The progress of medical imaging allow, now, to avoid unnecessary surgical interventions. We report the case of a 14-year old child who was admitted to hospital with left iliac fossa pain evolving over six days and gradually worsening. He didn’t suffer from transit disorders or associated urinary functional symptoms and he was afebrile. Abdominal palpation showed right iliac fossa tenderness. He was overweight with a BMI of 29. Laboratory tests didn’t show any inflammatory syndrome. Cytobacteriologic examination of the urine was negative. Abdominal x-ray without treatment didn’t show any hydroaeric level or calcification in urinary tract projections. CT scan objectified fat infiltration in the coeco-appendicular junction, with shuttle image containing fat surrounded by hyperdense ring, suggesting a torsion of the epiploic appendice. The child underwent symptomatic treatment with good clinical evolution.