Presentation
Presented to the emergency department (ED) with left-sided lower quadrant abdominal pain for 2 days.
Patient Data
A well-defined fat-containing lesion reading -32HU with a hyperdense ring
Case Discussion
A 35-year-old male presented to the emergency department (ED) with left-sided lower quadrant abdominal pain for 2 days The pain was of stabbing nature with no radiation and associated with nausea. Vital signs were normal. Physical examination demonstrated left lower quadrant tenderness. Laboratory workup was normal. A computed tomography (CT) scan of the abdomen and pelvis was obtained, which displayed a 2.8 × 2.5 cm area of focal inflammation in the lateral margin of the junction of descending and sigmoid colon, demonstrating a high-density ring with mild surrounding inflammatory fat stranding suggestive of epiploic appendagitis.
Location and appearance by CT allow for differentiation of epiploic appendagitis from omental infarction. Epiploic appendagitis occurs most commonly along the anterior sigmoid colon while Omental infarction typically occurs deep to the anterior abdominal musculature within the right abdomen and may lack the hyperdense ring of inflammatory change surrounding the central fat attenuation.
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