What is Epiploic Appendagitis (EA)
Epiploic appendagitis is swelling and irritation of pouches (epiploic appendages) that are attached to the end portion of the large intestine (colon).
These pouches contain fat and are attached to the outside of the colon. This condition causes sudden pain in the lower abdomen.
EA is rare, and it usually goes away on its own. It can feel like other abdomen (abdominal) conditions, such as appendicitis, a gallbladder attack (cholecystitis), or diverticulitis.
What are the causes?
This condition may be caused by:
- Blocked blood flow due to a blood clot.
- Twisting (torsion) of the epiploic appendages.
- Conditions that cause swelling and inflammation of nearby tissue, such as long-term (chronic) diarrhea, Crohn disease, or ulcerative colitis.
What increases the risk?
You are more likely to develop this condition if:
- You are 40–50 years old.
- You are male.
- You are overweight.
What are the signs or symptoms?
The most common symptom of this condition is lower abdominal pain that starts suddenly and can be severe. Pain can be anywhere in the lower abdomen, but it is more common on the left side. The pain may get worse with movement or when pressing on your abdomen.
The following symptoms are possible, but they are not common:
- Fever.
- Nausea.
- Diarrhea or constipation.
How is this diagnosed?
Your health care provider may suspect EA if you have sudden lower abdominal pain without other symptoms. The condition may be diagnosed based on:
- CT scan. This is the best way to diagnose EA.
- Your symptoms and a physical exam.
- Ultrasound.
- A blood test (complete blood count, CBC).
- A procedure to look inside your abdomen using a lighted scope that has a tiny camera on the end (laparoscopy). This may be done to confirm the diagnosis.
How is this treated?
EA usually goes away without treatment. Your health care provider may recommend NSAIDs (such as aspirin or ibuprofen) to reduce pain and inflammation. In rare cases, if the condition does not improve or it keeps coming back, you may need surgery to remove the appendages.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have a fever.
- You develop nausea, vomiting, diarrhea, or constipation.
- Your pain gets worse.
- Your pain lasts longer than 10 days.
Get help right away if:
- You have severe pain that does not get better after you take medicine.
Summary
- Epiploic appendagitis (EA) is swelling and irritation of pouches (epiploic appendages) that are attached to the outside of the colon. The colon is the end portion of the large intestine.
- EA can feel like other abdominal conditions, such as appendicitis, a gallbladder attack (cholecystitis), or diverticulitis.
- EA usually goes away without treatment. Your health care provider may recommend NSAIDs (such as aspirin or ibuprofen) to reduce pain and inflammation.
