PMID- 25278036
OWN - NLM
STAT- MEDLINE
DCOM- 20150127
LR  - 20161125
IS  - 1365-229X (Electronic)
IS  - 0009-9260 (Linking)
VI  - 69
IP  - 12
DP  - 2014 Dec
TI  - Perigastric appendagitis: CT and clinical features in eight patients.
PG  - e531-7
AB  - AIM: To describe perigastric appendagitis (PA) on CT as a new and distinct 
      clinical entity to enable recognition and prevent additional unnecessary 
      investigation or intervention. MATERIALS AND METHODS: Institutional review board 
      approval was obtained and informed consent was waived. Retrospective review of 
      the clinical data and CT findings in eight patients with PA encountered over 10 
      years at one institution was performed. The English literature was reviewed and 
      summarized. Two experienced abdominal radiologists reviewed the CT images by 
      consensus. RESULTS: Seven of eight patients had moderate to severe epigastric 
      pain for 1-7 days. All eight patients (four men, four women; mean age 44 years, 
      range 33-81 years) had no fever or leukocytosis. All underwent abdominal CT which 
      showed ovoid fat inflammation along the course of the perigastric ligaments 
      (gastrohepatic, gastrosplenic, and falciform). Two had gastric wall thickening. 
      Although the inflammation was correctly described, the specific diagnosis was not 
      made on initial interpretation in five patients. Subsequently, they underwent 
      further diagnostic testing [an upper gastrointestinal examination and 
      hepatobiliary iminodiacetic acid (HIDA) cholescintigraphy, an upper endoscopy and 
      MRI examination, HIDA cholescintigraphy, another CT, and an MRI examination, 
      respectively]. The HIDA cholescintigraphy, upper GI examination, and upper 
      endoscopy examinations were normal. No repeated examination was performed on the 
      other three patients. Pain resolved spontaneously in all within two days. 
      CONCLUSION: Perigastric appendagitis can present with an acute abdomen, which is 
      safely managed conservatively if diagnosed correctly. Radiologists should be 
      aware of the entity to avoid unnecessary intervention, and recognize the CT 
      findings of ovoid fat inflammation in the distribution of the perigastric 
      ligaments.
FAU - Justaniah, A I
AU  - Justaniah AI
FAU - Scholz, F J
AU  - Scholz FJ
FAU - Katz, D S
AU  - Katz DS
FAU - Scheirey, C D
AU  - Scheirey CD
LA  - eng
PT  - Journal Article
PL  - England
TA  - Clin Radiol
JT  - Clinical radiology
JID - 1306016
RN  - 0 (Contrast Media)
SB  - IM
EIN - Clin Radiol. 2015 Apr;70(4):457
MH  - Abdomen, Acute/*diagnostic imaging/pathology
MH  - Abdominal Cavity/*diagnostic imaging/pathology
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Contrast Media
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Image Enhancement/methods
MH  - Inflammation/*diagnostic imaging
MH  - Ligaments/*diagnostic imaging/pathology
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Tomography, X-Ray Computed/*methods
MH  - Torsion Abnormality/*diagnostic imaging/pathology
EDAT- 2014/10/04 06:00
MHDA- 2015/01/28 06:00
CRDT- 2014/10/04 06:00
PHST- 2014/03/11 00:00 [received]
PHST- 2014/08/11 00:00 [revised]
PHST- 2014/08/22 00:00 [accepted]
PHST- 2014/10/04 06:00 [entrez]
PHST- 2014/10/04 06:00 [pubmed]
PHST- 2015/01/28 06:00 [medline]
AID - S0009-9260(14)00414-0 [pii]
AID - 10.1016/j.crad.2014.08.020 [doi]
PST - ppublish
SO  - Clin Radiol. 2014 Dec;69(12):e531-7. doi: 10.1016/j.crad.2014.08.020.