An axial CT image of a 43-year-old man with left lower quadrant pain shows an oval fatty mass (arrow) with surrounding fat stranding. There is fascial thickening (arrowheads).
Epiploic Appendagitis

* Torsion of epiploic appendages results in vascular occlusion, leading to ischemia
* Inflammation of appendages is self limited. Rarely, it may result in adhesion, bowel obstruction, peritonitis, or abscess
* Common in 4th to 5th decades of life
* Acute pain, most in left lower quadrant – easily mistaken for acute diverticulitis

CT Appearance

* Anterior to colonic lumen, sigmoid colon > descending colon > cecum
* Oval fatty mass surrounded by inflammation, 1.5cm and 3.5cm size
* Central high-density focus represents venous thrombosis
* Colonic wall thickening rare

Singh AK. CT appearance of acute appendagitis. AJR Am J Roentgenol 2004;183:1303-1307.

Source: Case submitted by RadiologyinThai, Dr. Rathachai Kaewlai