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.
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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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