Caecal epiploic appendagitis: a rare diagnosis in a young patient with red herring right iliac fossa pain

Abstract

Introduction Epiploic appendagitis is an inflammation of the appendices epiploicae which are fat-filled pouches of peritoneum protruding from the colonic serosa. Appendices epiploicae are found ubiquitously in the caecum and colon except for the rectum. They were first described by Vesalius in 1543 [1], but only gained popularity in 1853 when Virchow proposed their detachment as a source of intraperitoneal loose bodies [2]. They typically emerge along the taenia (taenia Libera and omentalis), in two rows in the caecum, ascending colon, descending colon and the sigmoid colon. But, in the transverse colon, they align in a single row as the taenia omentalis provides an attachment for the greater omentum. Due to their distribution over the entire colon, inflammation of the appendages may mimic various acute abdominal conditions [3]. Here we describe the first reported case of epiploic appendagitis mimicking as acute appendicitis in Sri Lanka.