CT features of primary epiploic appendagitis.

Objective: The aim of this study is to describe the computed tomography (CT) findings of primary epiploic appendagitis (PEA). Methods: We reviewed the clinical records and CT images of 14 consecutive patients in Singapore who presented with acute abdominal pain from July 2000 to April 2004 and had radiological signs of PEA. Results: Hyperattenuated ring with adjacent fat stranding was present in all the patients. The central high attenuation dot was seen in 42.9% (6/14) of the patients. We observed a lobulated fatty mass in 21.4% (3/14) of our patients. All patients recovered during clinical follow-up. Conclusions: We believe the lobulated appearance of PEA is due to two or more, contiguous infarcted epiploic appendages lying in close proximity. This appearance further aids in the diagnosis of PEA and helps differentiates the condition from omental infarction. Recognizing the CT signs of PEA should allow a confident diagnosis and avoid unnecessary surgery.