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World J Gastroenterol. Oct 28, 2013; 19(40): 6842-6848
Published online Oct 28, 2013. doi: 10.3748/wjg.v19.i40.6842
Published online Oct 28, 2013. doi: 10.3748/wjg.v19.i40.6842
Differential diagnosis of left-sided abdominal pain: Primary epiploic appendagitis vs colonic diverticulitis
Jeong Ah Hwang, Sun Moon Kim, Hyun Jung Song, Yu Mi Lee, Kyung Min Moon, Chang Gi Moon, Hoon Sup Koo, Kyung Ho Song, Yong Seok Kim, Tae Hee Lee, Kyu Chan Huh, Young Woo Choi, Young Woo Kang, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon 302-718, South Korea
Woo Suk Chung, Department of Diagnostic Radiology, Konyang University College of Medicine, Daejeon 302-718, South Korea
Author contributions: Hwang JA, Kim SM contributed equally to this work; Hwang JA, Kim SM, Chung WS designed the research; Koo HS, Song KH, Kim YS, Lee TH, Huh KC, Choi YW, Kang YW collected the data; Hwang JA, Song HJ, Lee YM, Moon KM, Moon CG analyzed and interpreted the data; and Hwang JA wrote the paper.
Correspondence to: Sun Moon Kim, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University College of Medicine, 685 Gasuwon-dong, Seo-gu, Daejeon 302-718, South Korea. ismkim@kyuh.ac.kr
Telephone: +82-42-6009370 Fax: +82-42-6009095
Received: May 6, 2013
Revised: August 1, 2013
Accepted: September 13, 2013
Published online: October 28, 2013
Processing time: 188 Days and 15.7 Hours
Revised: August 1, 2013
Accepted: September 13, 2013
Published online: October 28, 2013
Processing time: 188 Days and 15.7 Hours
Core Tip
Core tip: The clinical symptoms of primary epiploic appendagitis (PEA) and acute colonic diverticulitis (ACD) are similar in patients presenting with left-sided abdominal pain. In our study, the patients with PEA had well-localized abdominal tenderness, whereas those with ACD presented with slightly diffuse abdominal tenderness. The patients with ACD showed fever, rebound tenderness, and leukocytosis more often than those with PEA. When patients have well-localized abdominal tenderness without associated systemic manifestation or laboratory abnormalities, clinicians should suspect a diagnosis of PEA and consider a computer tomography (CT) scan. The characteristic CT findings of PEA may enable clinicians to accurately diagnose the disease.