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Title: Epiploic appendagitis – an uncommon cause of pelvic pain in the obese female.
Author: Harrington, Patrick
Issue Date: 2017
Conference Name: Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2017 Annual Scientific Meeting
Conference Date: October 29th – November 1st
Conference Place: Auckland, New Zealand
Abstract: Introduction: Epiploic appendagitis is an uncommon, usually benign but exquisitely painful inflammation of the adipose appendages that are located on the colon. It can prove to be a diagnostic dilemma and may be mistaken for diverticulitis, appendicitis or indeed in this case ovarian torsion leading to unnecessary admission, administration of antibiotics or surgical procedures. Methods: I present the case of a morbidly obese nursing student who presented with severe left iliac fossa pain in the setting of a known left ovarian cyst. She was initially thought to have ovarian torsion but at laparoscopy was discovered to have this infrequent and self‐limiting non‐gynecological condition. Results: Epiploica are pedunculated protrusions of fatty, serosa covered structures found along the entire course of the colon but more common and generally larger in the transverse and sigmoid colon. Each appendage has its own blood supply and they are greater in size, more abundant and most obvious in patients with increased BMI and in those who have recently lost weight. Acute torsion causes ischemia and infarction with aseptic fat necrosis and spontaneous venous thrombosis. While epiploic appendagitis itself is quite rare the type encountered in this case‐ that in the descending colon‐ is the least frequently occurring at 2%. Diagnosis primarily relies on imaging modalities such as CT with the most common finding being mesenteric stranding, fat density ovoid lesions with surrounding inflammation, occasionally there is a high‐attenuated dot within the inflamed appendage representing a thrombosed draining vein. Discussion: I discuss the clinical manifestations, appropriate diagnostic tools and management of this condition.
Internal ID Number: 01238
Type: Conference
Appears in Collections:Research Output

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