Mustafa KOPLAY, Seda ÖZBEK, Mesut SİVRİ, HÜSNÜ ALPTEKİN, Hasan ERDOĞAN, ALAADDİN NAYMAN

Primer epiploik apandisit: Klinik ve radyolojik görüntüleme bulguları

Amaç: Primer epiploik apandisit (PEA), klinik semptomla- rından dolayı akut apandisit ve divertikülit gibi hastalıkları taklit edebilen, nadir ve kendini sınırlayan bir hastalıktır. Bu retrospektif çalışmada primer epiploik apandisitin kli- nik ve radyolojik görüntüleme özellikleri tartışıldı. Yöntemler: Ağustos 2010 ve Aralık 2012 tarihleri arasın- da PEA tanısı alan 10 hastanın klinik, laboratuar ve bilgi- sayarlı tomografi (BT) bulguları gözden geçirildi. Bulgular: On hasta (1 kadın ve 9 erkek) PEA tanısı aldı. Yaş ortalaması 37,1 (15-63) yıl idi. İki hastada (%20) sağ alt kadran ağrısı, 7 hastada (%70) sol alt kadran ağrısı ve 1 hastada (%10) yaygın ağrı mevcuttu. Hiçbir hastada ateş yoktu. Sadece 2 hastada lökositoz görüldü. 3 hasta- da bulantı, 1 hastada kusma gibi gastrointestinal semp- tomlar vardı. Tüm hastalarda, BT’de yüksek dansiteli pe- riferik bir halka ile çevrili perikolonik yerleşimli yağlı kitle gözlendi. Tüm hastalarda semptomatik tedavi yapıldı. Sonuç: Atipik semptomları ve labaratuar bulguları olan akut karın ağrılı tüm hastalarda ( özellikle alt kadran ağrı- sı), PEA ayırıcı tanıda düşünülmelidir. Doğru tanı ve ge- reksiz cerrahi işlemleri önlemek için tanıda karakteristik görüntüleme bulguları olan BT kullanılmalıdır.

Primary epiploic appendagitis: Clinic and radiologic imaging findings

Introduction: Primary epiploic appendagitis (PEA) is a rare and self-limiting disease that can mimicking acute apendicitis and diverticulitis because of the clinical symptoms. The present retrospective study was discussed to clinical and radiologic characteristics of PEA. Methods: We reviewed the clinical, laboratory and computed tomography (CT) findings of 10 patients with PEA between August 2010 and December 2012. Results: Ten patients (1 female and 9 males) were diagnosed with PEA. The average age was 37.1 (15-63) years. Abdominal pain was localized to the right (2 cases, 20%) or left (7 cases, 70%) lower quadrants and generalized (1 cases, 10%). All patients were afebrile. Only two patients showed leukocytosis. There were gastrointestinal symptoms such as nausea (3 patients) and vomiting (1patient). In all cases, a pericolic fatty mass with a hyper attenuated ring was observed on CT. All of the patients were treated symptomatic. Conlusion: In patients have atypical symptoms and laboratory values with abdominal pain (especially left lower abdominal pain), PEA should be considered in differential diagnosis. For correct diagnosis and avoid unnecessary surgery, CT must be used in diagnosis because imaging findings characteristic of the disease.

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