Perigastric appendagitis

Last revised by Rania Adel Anan on 15 Dec 2023

Perigastric appendagitis is a rare inflammatory/ischemic process involving the perigastric ligaments (gastrohepatic, gastrosplenic and falciform ligaments).

Along with epiploic appendagitis and omental infarction, perigastric appendagitis falls under the umbrella of intraperitoneal focal fat infarction, with each entity having similar underlying mechanisms and radiological appearances, and mimicking other acute abdominal diseases.

Acute and severe abdominal (epigastric) pain in absence of fever.

Peritoneal ligaments contain uneven quantities of extraperitoneal fat.

Similar to epiploic appendagitis and omental infarction, perigastric appendagitis occurs when perigastric ligament appendages spontaneously twist causing vascular compromise and infarction.

Oval heterogeneous fat density focus with mild surrounding fat stranding along the course of the gastrohepatic (anterior to the stomach), gastrosplenic (posterior to the stomach), and falciform (anterior to the liver) ligaments.

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