Epiploic Appendagitis

Epiploic appendagitis (EA) is a rare condition that can cause severe belly pain. It happens when blood flow is cut off from an area of the colon.

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A sudden belly ache can sideline even the healthiest person. Abdominal pain is a common symptom of many different conditions from mild to life-threatening. Epiploic appendagitis (EA) is a rare condition that can cause severe belly pain. It happens when blood flow is cut off from an area of the colon. You may hear the condition called primary epiploic appendagitis. It can be mistaken for appendicitis or diverticulitis.

Your doctor can detect this condition with an ultrasound or a CT scan. The condition usually goes away on its own.

About EA

Epiploic appendages are normal pouches of fat. They are found on the outside surface of the colon. Each pouch has its own blood supply that keeps it healthy. But these pouches can become twisted or blocked. This cuts off blood supply to the tissue. The result is pain, most commonly in the left lower abdomen. It can also cause tissue death (necrosis).

EA more often affects overweight men in their 40s and 50s. But can occur at any age and in women too.

Symptoms of EA

Symptoms of EA are often vague and can be a sign of other conditions. They may include:

  • Lower belly pain.

  • Feeling very full after eating.

  • Vomiting.

  • Bloating.

  • Diarrhea.

  • A low-grade fever.

Your doctor will ask you questions about your symptoms and do a physical exam. They may order imaging tests like a CT scan or an ultrasound of your belly to help find the cause of your symptoms.

Treatment for EA

EA doesn't usually need treatment other than over-the-counter pain medicines. If pain is severe, your doctor may give you a limited prescription of opioids. Follow your doctor's specific instructions. EA should go away on its own in a couple weeks.

Rarely, surgery may be needed to remove an inflamed fat pouch. Surgery is reserved for appendagitis when symptoms like fever, nausea and vomiting, or pain do not resolve with conservative management. Some of the rarer complications of appendagitis mentioned below may also need surgery.

Possible complications of EA

Complications may include:

  • One part of the intestine sliding into the next, like a telescope. This is called intussusception.

  • Bowel obstruction.

When to call your doctor

Contact your doctor if you have:

  • A fever of 100.4°F (38°C) or higher, or as advised by your doctor.

  • Chills.

  • Belly, pain, cramps, or tenderness that doesn’t get better with over-the-counter medicines or that seems to be getting worse.

  • Constipation, diarrhea, or changes in bowel habits.

  • Ongoing nausea and vomiting.

  • Bleeding from your rectum.