On Oct. 31 my husband and I were walking home from the grocery store and I was carrying a slightly heavy backpack. My lower left side began hurting and got steadily worse until I went to the er the next day. The dr. said he thought the cat scan showed eppilloic appendigitis an sent me home with pain medicine. I went back the next day because the pain was worsening and he called in a surgeon who admitted me for 4 days. During that time they did another cat scan and a colonoscopy which they said were normal. I was then released an sent home with more pain medicine.
The pain continued as it had been and seemed to be getting more intense and then I started having problems with nausea, vomiting about a half to one hour after eating as well as diarrhea. I went back to the er and they did another cat scan and blood work and urine and said it was all normal and sent me home with pain medicine. I have been to the er about 5 times since I was released from the hospital. Tonight I went back because I have been running a fever for 3 days as well as the other symptoms still ongoing. They did the usual blood and urine tests and of course sent me home with pain medicine.
My husband and I are completely frustrated because we are tired of the pain, vomitine, and continual trips to the er with no results. I had a hysterectomy in 1991 and had my left ovary removed so there is not that there to possibly be a problem. Do you have any ideas at all what it could be and what I could maybe do for this? Any suggestion at all would be so helpful.

Answered by: Maria/MDHealthForum.com Team

Our abdominal and pelvic cavities are lined and covered by a thin membrane which is referred to as the peritoneum. The peritoneum has small fat-filled pouches situated along the colon and upper part of the rectum, these pouches are called epiploic appendices. The benign inflammatory process of these appendages is called Epiploic appendagitis .

Epiploic appendagitis is often caused by torsion. Obesity, vigorous stretching and heavy exercise are considered to be possible predisposing factors that may cause torsion of the appendage. Torsion may lead to decreased blood supply (ischemia), formation of blood clots within its blood vessels and may lead to necrosis. As a manifestation of this inflammatory process, the patient will experience focal, sharp, acute abdominal pain. Symptoms such as nausea and vomiting are uncommon. Usually patients with this type of inflammation are afebrile (no fever). The laboratory values such as white blood cell count can be slightly elevated or sometimes within normal range. Epiploic appendagitis is revealed in CT scan as a fat density lesion, oval shaped, about 2–4 cm in size the inflammatory changes in its surroundings are also apparent.

Epiploic appendagitis is a self-limiting condition-just like the common cold which goes away even without intervention. Sometimes we get relieved of self-limiting diseases because our bodies make use of their own healing mechanisms. Because of its benign and self-limiting nature, epiploic appendagitis is usually managed conservatively with the administration of analgesics. Complete resolution commonly take place between 3 days to 2 weeks. Most of the patients respond to treatment in 7 days or less. Complications are said to be uncommon, they include abscess, intestinal obstruction and intussusception- the telescoping or prolapse of a portion of the intestines intestine within another immediately adjacent part. It would be helpful to ask the opinion of your doctor whether you need to undergo diagnostic procedures to find out whether the persistence of symptoms are indicators of complications or due to other problems like inflammatory bowel disease.