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Age: 81

Sex: Female

Indication: Left lower quadrant pain

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Case #7


Findings

  • Lower chest
    • Calcifications of the aortic valve, mitral annulus, and coronary arteries
    • 6 mm left lower lobe pulmonary nodule and 5 mm pleural based left lower lobe pulmonary nodule
    • Mild atelectasis/scarring in the right middle lobe
    • Mild bibasilar subpleural reticulation
  • Abdomen/Pelvis
    • Oval fat-containing structure adjacent to the proximal sigmoid colon with a hyperdense rim and surrounding fat stranding
    • Colonic diverticulosis
    • No bowel obstruction
    • Focal fatty infiltration in the liver adjacent to the falciform ligament
    • 2.5 cm intermediate density left adrenal nodule
    • Subcentimeter bilateral renal hypodensities which are too small to characterize
    • Heavy atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
  • MSK
    • No acute findings
    • Multilevel degenerative changes of the spine
    • Remote posttraumatic deformity of the right iliac wing


Diagnosis

  • Epiploic appendagitis

Sample Report

Findings suggestive of acute epiploic appendagitis adjacent to the proximal sigmoid colon.

No bowel obstruction

Colonic diverticulosis without evidence of acute diverticulitis.

Indeterminate 2.5 cm left adrenal nodule. Consider adrenal protocol CT or MRI for further evaluation if prior imaging is not available to document stability.

Left lower lobe pulmonary nodules. Consider followup chest CT in 12 months if prior imaging is not available to document stability.


Discussion

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Images

Circumscribed fat density structure with surrounding fat stranding adjacent to the proximal sigmoid colon consistent with acute epiploic appendagitis (red arrow).



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