Epiploic appendagitis is a rare inflammatory condition that affects the small fat-filled pouches on the colon or large intestine.
People who have epiploic appendagitis may experience severe lower abdominal pain, nausea, and vomiting.
Although epiploic appendagitis can cause significant pain, doctors can easily treat it with conservative pain management and, in some cases, antibiotics.
Continue reading to learn more about epiploic appendagitis, including its causes and symptoms. We also discuss how doctors diagnose and treat this condition.
Epiploic appendagitis refers to the inflammation of small pouches on the colon or large intestine. These pouches are called epiploic appendages.
These pouches help the body absorb nutrients, and they protect blood vessels in the large intestine. Most people have about 50–100 epiploic appendices.
Epiploic appendagitis occurs if something cuts off the blood supply to these pouches. The lack of blood flow causes inflammation of the fatty tissue, resulting in severe lower abdominal pain.
People may confuse epiploic appendagitis with other conditions, including:
Epiploic appendagitis develops as a result of restricted blood flow to the epiploic appendages, which can occur for different reasons.
There are two types of epiploic appendagitis:
Primary epiploic appendagitis
Primary epiploic appendagitis can occur when an epiploic appendage twists around itself, cutting off its blood supply.
Sometimes, a blood clot forms in one of the blood vessels supplying an epiploic appendage.
Secondary epiploic appendagitis
In secondary epiploic appendagitis, the inflammation of the large intestine or nearby organs, such as the appendix or gallbladder, interrupts the blood flow to the rest of the colon.
If blood cannot get to the colon, this can result in pain in the epiploic appendages.
The symptoms of epiploic appendagitis include:
- pain that stays in one part of the abdomen
- pain that worsens with movement
- a mass in the abdomen
- low-grade fever
- a loss of appetite
In one 2011 study, researchers examined the records of 31 people with primary epiploic appendagitis.
They found that the condition usually affects the ascending and descending portions of the large intestine. As a result, most people experience pain on the left or right side of the lower abdomen.
It can be challenging for doctors to diagnose epiploic appendagitis through a physical examination alone because the condition causes nonspecific symptoms.
These symptoms are the same as those that also occur in other medical conditions, such as diverticulitis, appendicitis, and pelvic inflammatory disease.
Therefore, doctors who suspect epiploic appendagitis may perform a blood test to look at a person's white blood cell count. People who have epiploic appendagitis usually have normal or slightly raised white blood cell counts.
A significantly elevated white blood cell count is, therefore, most likely to indicate other inflammatory conditions, such as diverticulitis and appendicitis.
According to the authors of one retrospective study, an inflamed epiploic appendage appears as an oval shaped fatty lesion with a ring surrounding it.
Experts consider epiploic appendagitis to be a self-limiting disease, which means that the inflammation remains in one place.
Doctors typically recommend conservative pain management treatments, such as over-the-counter pain relievers. In some cases, a doctor may prescribe antibiotics to control the inflammation.
Unlike diverticulitis and appendicitis, primary epiploic appendagitis does not require surgery. However, doctors may recommend surgery if a person has secondary epiploic appendagitis due to an inflamed appendix.
Epiploic appendagitis occurs when an interruption in the blood supply to one or more epiploic appendages causes inflammation.
People should see a doctor if they experience severe pain in their lower abdomen that worsens when they move, cough, or take a deep breath.
Individuals with epiploic appendagitis have a relatively positive outlook. Although they may experience intense abdominal pain, this condition is self-limiting and does not usually cause complications.