Epiploic disorders. Conditions of the epiploic appendages
D. H. Carmichael and C. H. Organ Jr
Disorders of the epiploic appendages are rarely diagnosed preoperatively
and usually result from torsion with subsequent infarction. No diagnostic
test or clinical symptoms are pathognomonic of this process, which is a
disease of middle age and rarely life-threatening, and the most common
preoperative diagnosis is acute appendicitis. An analysis of case
information reported in the surgical literature has been combined with our
recent experience involving ten cases. Fifty-eight percent of the patients
in this collected series were male, and the average age in both sexes was
42 years. The sigmoid colon was the most frequent site of these disorders
(41.5%), and acute appendicitis was the most common preoperative diagnosis
(37.7%). The treatment is ligation, excision, and occasionally seromuscular
inversion. When encountered at exploration, this entity may represent the
sole etiology of the abdominal pain if exploration is otherwise negative.
