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Document Details :
Title: Een minder gekende oorzaak van acute epigastrische pijn
Author(s): BOHYN C, GRYSPEERDT S
Journal: Tijdschrift voor Geneeskunde
Volume: 73 Issue: 23 Date: 2017
A less known cause of epigastric pain
A 34-year-old man presented himself to the emergency department with acute onset of epigastric pain since three days and minor anorexia. The blood results showed raised c-reactive protein with a normal leucocyte count. The CT-scan showed an ovoid fatty infiltrated structure in the hepatogastric and falciform ligament with a hyperdens central dot and a surrounding hyperdens ring. These are pathognomic radiologic findings of a perigastric appendagitis. This self-limiting entity is not well-known and its etiology and disease course are similar to an appendagitis epiploica or omental infarction. However, an omental infarction will not show this hyperdens ring. Therefore, further investigations or a surgical intervention are unnecessary and should be avoided. The radiologist plays a crucial role in recognizing the typical CT-graphic image features, thereby avoiding further interventions for the patient. Supportive pain treatment is sufficient and spontaneous resolution will follow in a few days.