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Acute Epiploic Appendagitis | Radiology Board Review Case

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CT appearance of Acute Epipolic Appendagitis and its differentials

  • Acute epiploic appendagitis presents as acute lower quadrant pain.
  • Clinical features are similar to those of acute diverticulitis or, less commonly, acute appendicitis.
  • Differentials include acute omental infarction, mesenteric panniculitis, fat-containing tumor, and primary and secondary acute inflammatory processes in the large bowel.
  • CT features of acute epiploic appendagitis include:
    • An oval fat attenuation lesion
    • Usually, less than 3 cm in diameter with surrounding inflammatory changes, abutting the anterior sigmoid colon wall.
    • Associated signs include: Hyperdense rim and central dot sign.
    • Most commonly seen in the region of the sigmoid colon and ileocecal junction.
  • This is a self-limiting condition.

Watch the video for the detailed case discussion and PACS based image stack.

Here is a representative CT image of acute epiploic appendagitis:

acute epiploic appendagitis radiology features

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Reference and further reading: Acute Epiploic Appendagitis and Its Mimics

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About the Author


Dr. Amar Udare, MD, DNB

Dr Amar UdareDr. Amar Udare is a board-certified radiologist. He is currently working as a fellow radiologist at McMaster University, Canada. He has a passion for teaching (#FOAMrad and #FOAMed) and has been a semi-finalist for the 2018 and 2020 Aunt-Minnie Most effective Radiology Educator Awards. He has authored multiple peer-reviewed publications which can be accessed on PubMed and Google Scholar.

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