• acute appendagitis
• appendix epiploicae
• lower abdominal pain

• acute abdominal pain
• color doppler ultrasound
• contrast enhanced computed tomography
• primary epiploic appendagitis

• Abdomen, Acute/diagnosis
• Abdomen, Acute/therapy
• Adult
• Appendicitis/diagnosis
• Colon, Descending/diagnostic imaging
• Colon, Descending/pathology
• Colonic Diseases/diagnostic imaging
• Colonic Diseases/pathology
• Colonic Diseases/therapy
• Conservative Treatment
• Diagnosis, Differential
• Diverticulitis/diagnosis
• Humans
• Male
• Ultrasonography, Doppler, Color

Unspecific abdominal complaints including bloating and irregular bowel movements may be caused by carbohydrate malabsorption syndromes, e.g., lactose and fructose malabsorption. These symptoms were investigated with hydrogen (H₂) breath tests and correlated to carbohydrate malabsorption. During performing these H₂-breath tests the patient presented with an acute, localized, non-migratory pain in the left lower abdominal quadrant. Primary epiploic appendagitis is a rare cause of abdominal acute or subacute complaints and diagnosis of primary epiploic appendagitis (PEA) is made when computed tomography reveals a characteristic lesion. We report on a patient with co-occurrence of lactose and fructose malabsorption, which was treated successfully with a diet free of culprit carbohydrates, with PEA recovering without medication or surgical treatment within few days. Since the abdominal unspecific symptoms had been present for months, they appeared not to be correlated to the acute localized abdominal pain, therefore we speculate on a random co-occurrence of combined carbohydrate malabsorption and PEA.

• Carbohydrate malabsorption
• Fructose malabsorption
• Lactose malabsorption
• Primary epiploic appendagitis
• Computed tomography

• Abdominal Pain/etiology
• Adult
• Breath Tests
• Diet, Carbohydrate-Restricted
• Dietary Carbohydrates/metabolism
• Fructose/metabolism
• Gastrointestinal Absorption
• Humans
• Intestinal Diseases/complications
• Intestinal Diseases/diagnosis
• Lactose Intolerance/complications
• Lactose Intolerance/diagnosis
• Lactose Intolerance/diet therapy
• Lactose Intolerance/metabolism
• Malabsorption Syndromes/complications
• Malabsorption Syndromes/diagnosis
• Malabsorption Syndromes/diet therapy
• Malabsorption Syndromes/metabolism
• Male
• Tomography, X-Ray Computed

Epiploic appendagitis (EA) is rare cause of acute or subacute abdominal pain in patients on peritoneal dialysis (PD), where the diagnosis can be challenging as the clinical features, laboratory markers and imaging characteristics have not been described previously in this group of patients. Here, we present the management of a case of EA in a patient on PD and review published literature pertinent to the subject. The importance of establishing the diagnosis early by laparoscopy is emphasised.

• Epiploic appendagitis
• Peritoneal dialysis
• Abdominal pain
• Diagnosis
• Laparoscopy