Crohn's Disease Forum » Extra Intestinal Manifestations » Epiploic Appendagitis -- epiwhat???

12-24-2014, 01:56 AM   #1
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kristihelene's Avatar
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Location: Pittsburgh, Pennsylvania

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Epiploic Appendagitis -- epiwhat???

I have posted recently about having worsening pain over the last few weeks that has become unbearable. After seeing my PCP today, I got a CT scan that showed I have "epiploic appendagitis".... I have googled it, and my PCP actually called me at 11pm tonight to tell me this diagnosis! But according to her and google, it is super rare so she has little info beyond what I could find online. Has anyone else heard of this? Dealt with this? Some sites/doctors recommend surgery to correct, other's say not necessary. She has me on steroids and pain meds (it is EXTREMELY painful!) but wondering what the long term solution is in the real world! From what I can tell, it isn't necessarily directly related to my crohn's - its autoimmune (i think) and I am sure IBD predisposes me to this, but from what I can tell its not indicative of my disease flaring/spreading... Can anyone out there weigh in on this?

Crohn's :: 2007

Current Status: Lots of pain and not unable to work
* 2007 & 2011 ~ Open Small bowel resections
* 2013 & 2014 ~ adhesion lyses and endometriosis cauterization

Current IBD Tx:
* Remicade IV every 6 wks
* Methotrexate injections weekly
* Zofran before every meal and bed
* Vit B-12 injections monthly

Because having Crohn's isn't enough...
Dx: Inflammatory Arthritis, Migraines, Endometriosis, Excessive Daytime Sleepiness, & Fibromyalgia
12-26-2014, 12:59 PM   #2
David's Avatar
Join Date: Feb 2006
Location: Naples, Florida
I've never heard of it and have no advice. I just wanted to offer my support. I'm so sorry you're having to go through this
It's good to be back
12-26-2014, 01:13 PM   #3
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It's actually NOT rare. epiploic appendeges are small pieces of periotoneal like fatty tissue that sit on the outside of the colon- mostly the left side (sigmoid, and sometimes the upper or transverse part.) These little appendeges sometimes can twist and cut of its own little blood supply or for other reasons get inflamed, causing a heck of a lot of pain, even fever if they get infected. Usually because the epiploices are small, when this happens it is self limited and despite the acuity (pain, +/- fever) usually resolves on its own within 24-48 hours. Most often no intervention is needed but I guess it could in theory get severe if multiple ones are inflamed at once.

It is not related to IBD and I've seen a few cases (CT needed to confirm) and none of the patients had/has IBD.

It's a diagnosis we like to stump med students on during rounds during workup of abdominal pain, b/c though not extremely rare, is not that common either. It's a good thing it usually occurs on the left side, otherwise it would really mimic appendicitis which is right sided.

I hope this helps.

Crohn's Disease Forum » Extra Intestinal Manifestations » Epiploic Appendagitis -- epiwhat???
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