Epiploic Appendagitis
Epiploic appendagitis is a self-resolving condition that results from lack of blood flow to a localized lobule of fat sitting on the outside of the colon.
A sudden belly ache can sideline even the healthiest person. Abdominal pain is a common symptom of many different conditions from mild to life threatening. Epiploic appendagitis is a rare condition that can cause severe belly pain. It happens when blood flow is cut off from an area of the colon. You may hear the condition called primary epiploic appendagitis. It can be mistaken for appendicitis or diverticulitis.
Your healthcare provider can detect this condition with an ultrasound or CT scan. The condition usually goes away on its own.
About EA
Epiploic appendages are normal pouches of fat. They are found on the outside surface of the colon. Each pouch has its own blood supply that keeps it healthy. But these pouches can become twisted or blocked. This cuts off blood supply to the tissue. The result is pain, most commonly in the left lower abdomen. It can also cause tissue death (necrosis).
EA more often affects overweight men in their 40a and 50s. But can occur at any age and in women.
Symptoms of EA
Symptoms of EA are often vague and can be a sign of other conditions. They may include:
Lower belly pain
Feeling very full after eating
Vomiting
Bloating
Diarrhea
Low-grade fever
Your healthcare provider will ask you questions about your symptoms and will do a physical exam. They may order imaging tests like a CT scan or an ultrasound of your belly to help find the cause of your symptoms.
Treatment for EA
EA doesn't usually need to treatment other than over-the-counter pain medicines. If pain is severe, your provider may give you a limited prescription of opioids. Follow your provider's specific instructions. EA should go away on its own in a couple weeks.
Rarely, surgery may be needed to remove an inflamed fat pouch. Surgery is reserved for appendagitis when symptoms like fever, nausea and vomiting or pain do not resolve with conservative management. Some of rarer complications of appendagitis mentioned below may also require surgery.
Possible complications of EA
One part of the intestine slides into the next, like a telescope. This is called intussusception.
Bowel obstruction
When to call your healthcare provider
Fever of 100.4°F (38.0°C) or higher, or as advised by your provider
Chills
Belly, pain, cramps, or tenderness that doesn’t get better with OTC medicines or seems to be getting worse
Constipation, diarrhea, or changes in bowel habits
Ongoing nausea and vomiting
Bleeding from your rectum