Acute epiploic appendagitis at the tip of the appendix mimicking acute appendicitis: A rare case report with literature review.
Acute appendicitis
Acute epiploic appendagitis
Acute epiploic appendagitis of the appendix
Case report
Journal
World journal of gastrointestinal surgery
ISSN: 1948-9366
Titre abrégé: World J Gastrointest Surg
Pays: United States
ID NLM: 101532473
Informations de publication
Date de publication:
27 Aug 2019
27 Aug 2019
Historique:
received:
08
03
2019
revised:
04
06
2019
accepted:
27
07
2019
entrez:
17
9
2019
pubmed:
17
9
2019
medline:
17
9
2019
Statut:
ppublish
Résumé
Acute epiploic appendagitis of the appendix (AEAA) is a rare self-limiting inflammatory disorder of the epiploic appendages (EA) close to the vermiform appendix, which often times mimicking the presentation of acute appendicitis (AA). To date, very few cases of AEAA have been reported. We report a case of a 52-year old man with the clinical suspicion of AA, but post-operative specimen examination confirmed AEAA as the final diagnosis. A 52-year-old morbidly obese man presented to the emergency department with a 1-d history of the right lower quadrant (RLQ) abdominal pain. Physical examination revealed localized RLQ tenderness mimicking AA. The computed tomography abdomen was inconclusive, and a decision was made to perform laparoscopic appendectomy (LA). During the LA, an infarcted epiploic appendage at the tip of appendix and adherent to the abdominal wall was found, which was entirely excised. Final pathology showed congested and hemorrhagic epiploic appendage without any accompanied acute inflammatory changes in the wall of the appendix. Postoperative course was uneventful and he was doing well at seven months follow-up. The possibility of AEAA should be considered in patients clinically suspected of having AA. Surgery is considered for those refractory to conservative management, with inconclusive diagnosis or develop complications at presentation.
Sections du résumé
BACKGROUND
BACKGROUND
Acute epiploic appendagitis of the appendix (AEAA) is a rare self-limiting inflammatory disorder of the epiploic appendages (EA) close to the vermiform appendix, which often times mimicking the presentation of acute appendicitis (AA). To date, very few cases of AEAA have been reported. We report a case of a 52-year old man with the clinical suspicion of AA, but post-operative specimen examination confirmed AEAA as the final diagnosis.
CASE SUMMARY
METHODS
A 52-year-old morbidly obese man presented to the emergency department with a 1-d history of the right lower quadrant (RLQ) abdominal pain. Physical examination revealed localized RLQ tenderness mimicking AA. The computed tomography abdomen was inconclusive, and a decision was made to perform laparoscopic appendectomy (LA). During the LA, an infarcted epiploic appendage at the tip of appendix and adherent to the abdominal wall was found, which was entirely excised. Final pathology showed congested and hemorrhagic epiploic appendage without any accompanied acute inflammatory changes in the wall of the appendix. Postoperative course was uneventful and he was doing well at seven months follow-up.
CONCLUSION
CONCLUSIONS
The possibility of AEAA should be considered in patients clinically suspected of having AA. Surgery is considered for those refractory to conservative management, with inconclusive diagnosis or develop complications at presentation.
Identifiants
pubmed: 31523384
doi: 10.4240/wjgs.v11.i8.342
pmc: PMC6715586
doi:
Types de publication
Case Reports
Langues
eng
Pagination
342-347Déclaration de conflit d'intérêts
Informed consent statement: Informed consent for the publication of this work has been obtained.
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