Dr. Abhinav Balaji, Dr. P. Balaji, Dr. S. Selvakumar, Dr. S. Selvasankar


Disorders of the epiploic appendages are rarely diagnosed preoperatively and usually result from torsion with subsequent infarction.No diagnostic test or clinical symptoms are pathognomonic of this entity, which is a disease of middle age and rarely life-threatening. The majority of  cases occur in the sigmoid colon and present with left sided abdominal pain. Acute torsion of an appendage usually manifests as localised abdominal pain in one of the lower quadrants. Untreated, peritonitis or intestinal obstruction may ensue. The surgical treatment of appendicitis epiploicae is simple ligation and excision if an intraoperative diagnosis is made. We report a 65 year old female who presented with symptoms of left lower quadrant pain in the abdomen and with features of sub acute intestinal obstruction .The suspicion of epiploic appendagitis was established by the findings of a contrast-study computed tomography of the abdomen. A diagnostic laparoscopy was subsequently performed due to clinical deterioration of the abdominal pain despite antibiotic coverage. An infarcted epiploic appendage of the sigmoid colon was revealed, which was removed laparoscopically.



Full Text:



Vázquez-Frias JA, Castañeda P, Valencia S. Laparoscopic diagnosis and treatment of an acute epiploic appendagitis with torsion and necrosis causing an acute abdomen. JSLS 2000;4:247-50.

Patel VG, Rao A, Williams R. Caecal epiploic appendagitis: a diagnostic and therapeutic dilemma. Am Surg 2007;73:828-30.

Platts-Mills TF, Burg MD. Epiploic appendagitis. J Emerg Med 2008;11:1-2.

Sand M, Gelos M, Bechara FG, et al. Epiploic appendagitis – Clinical characteristics of an uncommon surgical diagnosis. BMC Surg 2007;7:11.

Ng KS, Tan AG, Chen KK, et al. CT features of primary epiploic appendagitis. Eur J Radiol 2006;59:284-8.

Bastidas JG, Danzy LE, Blackwell L. Epiploic appendagitis in a 24-year-old woman. Am J Emerg Med 2008;26:838.e1-2.

Deceuninck A, Danse E. Primary epiploic appendagitis: US and CT findings. JBR-BTR 2006;89:225.

UsluTutar N, Ozgül E, Oğuz D. An uncommon cause of acute abdomen – epiploic appendagitis: CT findings. Turk J Gastroenterol 2007;18:107-10.

Osadchy A, Shapiro-Feinberg M, Zissin R. Strangulated small bowel obstruction related to chronic torsion of an epiploic appendix: CT findings. Br J Radiol 2001;74:1062-4.

Shehan JJ, Organ C, Sullivan JF. Infarction of the appendices epiploicae. Am J Gastroenterol. 1966;46:469–476. [PubMed]

Elliott GB, Freigang B. Aseptic necrosis, calcification and separation of appendices epiploicae. Ann Surg. 1962;155:501–505. doi: 10.1097/00000658-196204000-00004. [PMC free article] [PubMed][CrossRef]

Ramdial PK, Singh B. Membranous fat necrosis in appendices epiploicae. A clinicopathological study. Virchows Arch. 1998;432(3):223–227. doi: 1 0 . 1 0 0 7 / s 004280050159. [PubMed] [CrossRef]

Carmichael DH, Organ CH. Epiploic disorders: conditions of the epiploic appendages. Arch Surg. 1985;120:1167–1172. [PubMed]

Chowbey PK, Singh G, Sharma A, Khullar R, Soni V, Baijal M. Torsion of appendices epiploicae presenting as acute abdomen: laparoscopic diagnosis and therapy. Indian J Gastroenterol. 2003;22(2):68–69. [PubMed]

Shamblin JR, Payne CL, Soileau MK. Infarction of an epiploic appendix. South Med J. 1986;79(3):374–375.doi:10.1097/00007611-198603000 0 0 0 3 0 . [ P u b M e d ] [CrossRef]

Bandopadhyay SK, Jain M, Khanna S, Sen B, Tantia O. Torsion of epiploic appendix: an unusual cause of acute abdomen. J Minimal Access Surgery. 2007;3:70–72. doi: 10.4103/0972-9941.33277.[PMC free article] [PubMed] [CrossRef]


  • There are currently no refbacks.