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Epiploic Appendagitis Clinically Masquerading as an Acute Diverticulitis

Razan A KhafajiCollege of Medicine, King Abdulaziz University, Jeddah, SAUHussain S GhandourahCollege of Medicine, Maastricht University, Maastricht, NLDSarah K AltamimiCollege of Medicine, Arabian Gulf University, Manama, BHRAfnan A AlwarthanCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAURenda Ali AlhabibCollege of Medicine, Qassim University, Qassim, SAUMazen N AlaiyarCollege of Medicine, AlMaarefa University, Riyadh, SAUIbrahim A AlomarCollege of Medicine, Qassim University, Qassim, SAUMeshari I AlayshanCollege of Medicine, Jouf University, Al-Jawf, SAUMohammed S AlmasoudiCollege of Medicine, Umm Al-Qura University, Mecca, SAUHashem A Jaml AllilCollege of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAUShahad Z MunshiCollege of Medicine, King Abdulaziz University, Jeddah, SAUSarah K AljamriCollege of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAUBasil S BagadeemCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAUMotaz S AttarCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAUFaisal Al-HawajCollege of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
Cureusjournal2021en
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Annotatsiya

Acute diverticulitis is a prevalent surgical condition that typically presents with lower abdominal pain and tenderness. However, the clinical and laboratory findings of diverticulitis are non-specific and other conditions may give similar manifestations. We present the case of a middle-aged woman with a left lower quadrant abdominal pain and fever of three days duration. On examination, she had tachycardia and localized tenderness in the left iliac fossa with rebound tenderness. There were no signs of peritonitis, including the rigid abdomen and decreased bowel sounds. The laboratory findings were suggestive of an inflammatory or infectious process. A computed tomography scan of the abdomen demonstrated a fat-density lesion anterior to the descending colon representing epiploic appendagitis. The patient was managed conservatively with non-steroidal anti-inflammatory drugs (lornoxicam 8 mg). The patient experienced gradual improvement and was discharged after four days of hospitalization. No surgical intervention was needed. The case highlighted the importance of considering epiploic appendagitis in the differential diagnosis of acute diverticulitis. An accurate diagnosis will prevent the patient from having unnecessary surgeries as conservative management is often sufficient in patients with epiploic appendagitis.

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