How would you recommend treating a woman, aged 30 years, who has intermittent right-lower-quadrant abdominal pain diagnosed on CT scan as epiploic appendagitis? The patient’s pain is frequently so incapacitating that she is forced to leave work. — Joanne L. Tanner, FNP-C, Cortland, N.Y.
Epiploic appendagitis is a fairly rare occurrence, but it is not usually serious (Med Sci Monit. 2012;18:CS48-CS51). Unlike appendicitis, in which the structure is anatomically normal, epiploic appendages are made of inflamed malformations of the serosal layers of the outer colonic wall.
Most cases resolve as the inflammation dissipates, and occasionally, the appendage will self-destruct through ischemia. Patients usually recover with conservative nonsurgical treatment. Laparoscopic removal results in complete healing and may be necessary in persistent cases. — Sherril Sego, FNP-C, DNP (184-1)
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