What is Epiploic Appendagitis & How is it Treated?

Epiploic Appendagitis is a pathological condition arising out of the abdominal region which is characterized by inflammation at the level of the epiploic appendices. These are small pouches of peritoneum which is filled with fat and is located along the colon.

Epiploic Appendagitis is a benign and self limiting condition and goes away on its own without any need for any specific treatment. It usually mimics the symptoms of acute appendicitis and is often at times confused with this condition due to the rarity of this condition.

Epiploic Appendagitis can occur on its own accord or it can be caused due to a secondary illness around the colon region. Individuals in the age range of 30 to 60 tend to get Epiploic Appendagitis more than the normal population.

Females and obese individuals are more predisposed to getting Epiploic Appendagitis than others. Anatomically speaking there are approximately 100 appendages spread across the colon and rarely in the rectum but these are mostly seen in the rectosigmoid junction. Torsion of the appendage is believed to be the most common cause for Epiploic Appendagitis.

As stated above, torsion of the appendage is believed to be the root cause for Epiploic Appendagitis. In some cases, venous thrombosis is also found to be the cause of Epiploic Appendagitis where the thrombosis or clot occurs at the level of epiploic appendage.

Some of the symptoms of Epiploic Appendagitis are:

• Severe pain in the abdominal region is the primary symptom of Epiploic Appendagitis.
• The pain may be sharp and stabbing in nature
• The area of the pain associated with Epiploic Appendagitis may be variable within the abdominal region meaning that it may present on the left side, right side, or the midline of the abdomen.
• The severity of the pain associated with Epiploic Appendagitis increases with attempts at passing urine or stool
• Nausea accompanied with vomiting

It should be noted here that the symptoms of Epiploic Appendagitis often mimic the symptoms of acute appendicitis, diverticulitis, and cholecystitis so symptoms related to these conditions may also be present.

The diagnosis of Epiploic Appendagitis is extremely difficult due to the rarity of the disease and also the fact that it mimics symptoms of various other medical conditions related to the abdomen. Thus despite a battery of specialized blood test a confirmatory diagnosis cannot be obtained.

Advanced imaging studies are recommended in the form of CT and MRI scans of the abdomen and pelvic region. These studies may detect an inflammatory process going on within the epiploic appendage confirming the diagnosis of Epiploic Appendagitis.

In majority of the cases, the diagnosis is basically incidental of Epiploic Appendagitis meaning that the tests may be done to rule out certain other medical conditions.

Some of the common methods used to diagnose Epiploic Appendagitis are ultrasound which may detect a mass around the epiploic appendage and CT scan which may show up inflamed epiploic appendage thus confirming the diagnosis of Epiploic Appendagitis.

As stated, Epiploic Appendagitis is a benign and self limiting condition and does not require any form of treatment. The treatment is mainly aimed at the symptoms caused by it. This may include pain medications to control the pain and NSAIDs to calm down the inflammation. In most of the cases, the symptoms go away within a matter of a week and the patient is completely cured of Epiploic Appendagitis.

In cases where there are frequent recurrences of this condition then a laparoscopic surgery may be recommended where the inflamed appendage is completely excised reducing to minimal the chances of recurrence of Epiploic Appendagitis.

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