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What Is Epiploic Appendagitis?

Epiploic appendices are small, fat-filled sacs that may be found along the surface of the upper and lower colon and rectum.
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  • Written By: Andy Josiah
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 21 July 2014
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Epiploic appendagitis (EA) is a term that describes the swelling or inflammation of the epiploic appendices. The term "epiploic appendagitis" came into existence in 1956. Knowledge of the condition, however, stretches to about a century before then, when German physician Rudolf Ludwig Karl Virchow studied the results of defective epiploic appendices.

The epiploic appendices, also known as appendices epiploicae, epiploic appendages or omental appendices, are fat-filled pouches of the peritoneum, which line the body's abdomen. They are located externally along the colon, particularly in its transverse and sigmoid sections. Their name is derived from the Greek word "epipleein." They are so named because of the part of the peritoneum where they can be found, called the greater omentum, which seems to "float" on the intestines situated below it.

Each appendage usually measures about 0.2 to 2 inches (or 0.5 to 5 cm). The role of the epiploic appendages is largely unknown. Some physicians, however, believe that their thickness—about 0.4 to 0.8 inches (1 to 2 cm)—serves as a defense wall against the spread of infections across the peritoneum.

Epiploic appendagitis occurs when excessive gas content stretches the abdomen. This condition is known as torsion, and in most instances, the swelling of the appendices usually occur in the sigmoid colon. Although EA can appear irrespective of age and gender, it is most common in with men in their 20s to 50s.

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Acute abdominal pain is the most common symptom of epiploic appendagitis. It is very easy, however, to misdiagnose it as acute appendicitis or diverticulitis; the latter is a term applied to a digestive disease of the colon. The pain typically occurs at the left lower quadrant, which is the area between the abdomen's mid-line and the navel. Fevers are absent in people with EA. In fact, apart from the abdominal pain, there are no obvious signs of illness. Thus proper diagnosis is difficult with this particular disease.

Generally, however, epiploic appendagitis is a harmless, self-limiting condition. Physicians often merely prescribe an analgestic, or painkiller. EA can resolve itself in as little as three days, although resolution can take up to two weeks in some cases. Complications from treatment are incredibly uncommon, and the chances of recurrence are low.

Alternate terms for epiploic appendagitis include appendicitis epiploica, or simply appendagitis. Members of the medical community, however, limit the use of the aforementioned terms because they can be confused with acute appendicitis. Like EA, acute appendicitis is an inflammatory condition, but it affects the appendix.

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Gardener
Post 9

Wow. I see I'm not alone. I had pain for 3 days and then on the 4th day I went to the ER. The pain was moderate, but not debilitating and I was so busy at work that I put off going to the dr. I truly thought maybe I was constipated or something like that, so I did what I could with OTC stuff -- and you know what that means when you're treating constipation. Ugh.

So I went to the ER and they were great. I was in and out in under three hours and that was on a Saturday afternoon even. He told me that they don't know what causes this, but that it's rare and that he probably sees a case of this every six months or so. He said it's so rare that he has to type the diagnosis into the ER computer because it's not even on the list for him to choose from.

So he gave me two antibiotics to help prevent anything further from occurring, and he gave me an anti-inflammatory and a pain killer -- all to take for seven days. So now it's two days later and I still have the moderate pain, but it's not constant anymore; it's off and on.

I just thank God that it wasn't something more serious because abdominal pain can be a lot of things.

anon941217
Post 8

I am just recovering from epiploic appendagitis. I started feeling slight pain on mid Sunday evening on my right side. By Monday morning I could barely walk due to the pain. I went to the ER and the doctor took a sonogram. They ruled out appendicitis because I didn't have any of the other symptoms other than the pain. They told me to take over the counter pain killers and acid reducer and then sent me home. I was to return if the pain got worse.

I went to my PMD and he ordered a CT scan. The CT scan revealed I had epiploic appendagitis. My doctor prescribed an anti-inflammatory and acid reducer. After just one dose of the anti-inflammatory medication, I began to feel a whole lot better. By the next day, I didn't even need the painkillers any longer.

wavy58
Post 7

@orangey03 – Your pain sounds a lot like what I experienced. My doctor thought I merely had irritable bowel syndrome, and she gave me heartburn medicine, along with painkillers. She told me to come back if my symptoms didn't improve in a week.

Well, eight days later, I was still in agony. As soon as the pills wore off, the pain kicked in again.

My doctor ordered a CT scan, and what they found was more alarming than epiploic appendagitis. They saw that I had multiple cysts on my kidneys, and this could be causing abdominal pain.

However, I'm still curious as to whether I might have epiploic appendagitis in addition to polycystic kidney disease. They were so put off by that finding that they didn't mention any intestinal issues.

lighth0se33
Post 6

For years, my dad believed he had epiploic appendagitis. His brother had it, so when he started getting the same symptoms, he just assumed he had the same condition.

He took pain medicine and waited for it to go away. Usually, it did stop. Last year, though, he had an episode that would not let up, even after two weeks.

He got a CT scan and found out he actually had diverticulitis. He had never been to the doctor about this before, or they probably would have scanned him and found it right away.

He had to have antibiotics to treat an infection caused by the condition. He also had to alter his diet a little to prevent future problems.

orangey03
Post 5

@seag47 – I can't imagine enduring that pain all weekend! I had to go to the emergency room within two hours of my onset of pain.

I felt really bloated and uncomfortable at first, but I could deal with that. What I couldn't handle was the sudden, terrible pain that made me double over. I could not straighten up. It was as though someone had a rope about my waist and they were pulling it tighter.

Afraid that something inside me was about to burst, I went to the hospital. I was surprised to learn that I didn't need surgery. I gratefully downed the pain medication, and in a week, my symptoms were gone completely.

seag47
Post 4

I felt a lot of pain in my lower abdomen after wearing some snug jeans. At first, I thought that they were causing the pain by pressing on my guts. However, when I got home and took them off, the pain persisted.

It was only in one spot, and though changing out of the tight jeans helped a little, the stabbing refused to go away. I felt like someone had taken a knife and thrust it into my abdomen, left it there, and walked away.

This happened on a Friday night, so I had to wait until Monday morning to see my doctor. She did a CT scan and figured out that it was epiploic appendagitis. She prescribed some pretty hefty pain pills that worked wonders, though I did have to keep taking them every four hours, or the pain would return.

turquoise
Post 3

I'm a first year med student and we just talked about epoloic appendagitis in class. I think the appendix and epoloic appendixes can be grouped together because neither of their functions are known and neither make themselves apparent unless there is some sort of a problem.

We still don't know what the epoloic appendixes do, but we are at least able to locate and diagnose appendagitis which was not easy before. My professor said that the only way to diagnose epiploic appendagitis before CT scans was to cut the person up and look.

At least we don't have to do that anymore, and I think as more research is done, we might be able to figure out exactly what it is they do.

ddljohn
Post 2

@fify-- Actually, there is a epiploic appendagitis treatment, it's surgery. Doctors generally don't do this unless the condition is severe, but it is an option.

My best friend had her appendages surgically removed because apparently the appendages were very long which made them highly prone to this condition. I think when the appendages are large and long, it becomes easier for them to twist and turn due to gas.

She is very happy to have had the surgery because she had to make frequent visits to the hospital because of the pain and it was ruining her life. The pain is completely gone now.

If your epiploic appendagitis reoccurs, you might want to ask your doctor about surgery.

fify
Post 1

Even though epiploic appendagitis heals pretty quickly and there is no actual treatment for it, it can cause a lot of pain!

I've had it happen to me twice and ended up in the ER because of a sharp pain under my rib. The first time, the doctor couldn't find anything and sent me home with pain killers. It went away on its own after a couple of days.

About a year later, it happened again and I again ended up in ER. This time I had more extensive tests done and the doctor diagnosed epiploic appendagitis. I was so happy that the reason for the pain was finally found but it turns out the treatment is the same as what it was the first time. Just rest and pain killers.

At least I know what the epiploic appendagitis symptoms are now and I won't freak out so much if it happens again.

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