Epiploic appendagitis: an unusual cause of acute abdominal pain

Abstract

Objective: To describe a clinical case of epiploic appendagitis as a rare cause of acute abdominal pain, highlighting its differential diagnosis, management, and classification with the scientific literature. Case presentation: A 32-year-old male patient with no significant medical history presented with four-day history of abdominal pain located in the mesogastrium and hypogastrium, migrating to the left iliac fossa, with no fever or vomiting. Abdominal ultrasound showed inflammatory signs compatible with acute appendicitis, which is why the patient was taken to surgery. During laparotomy, a necrotic epiploic appendix was found in the sigmoid colon, which was resected along with the cecal appendix. Favorable postoperative outcome. Results: Histopathological examination confirmed ischemic necrosis and acute inflammatory process of the epiploic appendix, as well as congestive changes in the cecal appendix. Conclusions: Epiploic appendagitis is a rare entity that can mimic acute surgical abdomen. Timely clinical and imaging recognition avoids unnecessary procedures and favors conservative management.