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The inflammation of the epiploic appendages normally resolves on its own for most patients. It is possible however uncommon for acute epiploic appendagitis to result in adhesion, bowel obstruction, intussusception, intraperitoneal loose body, peritonitis, and/or abscess formation. [2] Treatment consists of reassurance of the patient and analgesics.
Patients commonly have elevated C-reactive protein and a high white blood cell count. [10] In Asia it is usually on the right (ascending colon), while in North America and Europe, the abdominal pain is usually on the left lower side (sigmoid colon). [2] [8] There may also be fever, nausea, diarrhea or constipation, and blood in the stool. [1]
CT scan showing extensive diverticulosis of the sigmoid colon Diverticular disease Whole slide of a transverse section of the left colon with diverticulosis. Diverticulosis is defined by the presence of multiple pouches (diverticula) in the colon. [22] In people without symptoms, these are usually found incidentally during other investigations.
Computed tomography of the abdomen is not routinely necessary, but may show thickening or inflammation in the distal colon (sigmoid colon) with associated diverticulosis. Treatment may consist of antibiotics, aminosalicylates (mesalamine), or prednisone. In rare cases, surgery with segmental resection may be considered.
About 10% of cases have a more serious cause including gallbladder (gallstones or biliary dyskinesia) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%). [2] More common in those who are older, ischemic colitis , [ 5 ] mesenteric ischemia , and abdominal aortic aneurysms are other serious causes.
Hinchey Classification is used to describe perforations of the colon due to diverticulitis.The classification was developed by Dr. E John Hinchey (1934–present), a general surgeon at the Montreal General Hospital and professor of surgery at McGill University.
A large pyogenic liver abscess presumed to be the result of appendicitis. There are several major forms of liver abscess, classified by cause: [3] Pyogenic liver abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States. Amoebic liver abscess due to Entamoeba histolytica accounts for 10% of cases ...
Endoscopic image of ulcerative colitis affecting the left side of the colon. The image shows confluent superficial ulceration and loss of mucosal architecture. Crohn's disease may be similar in appearance, a fact that can make diagnosing UC a challenge. H&E stain of a colonic biopsy showing a crypt abscess, a classic finding in ulcerative colitis