Torsion of the primary epiploic appendagitis: A case series and review of the literature
Uslu, Hatim Yahya
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BACKGROUND: Differential diagnosis and appropriate treatment of epiploic appendagitis (EA) is adilemma 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) whowere diagnosed as having EA upon presenting to the emergency department or at the time of dischargebetween April 2002 and September 2008 were included.RESULTS: The major presenting symptom was abdominal pain. Physical examination revealedwell-localized tenderness in all cases (n 12); in addition, rebound tenderness and distention were alsoobserved. Laboratory blood tests were normal except for 4 patients who had leukocytosis. Seven caseswere 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 otherintra-abdominal acute conditions. An abdominal computed tomography scan has a significant role inaccurate diagnosis of EA before surgery to avoid unnecessary surgical interventions.