Emergency casebook
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Acute epiploic appendagitis is an uncommon cause of abdominal pain. It is caused by torsion of an epiploic appendage or spontaneous venous thrombosis of a draining appendageal vein. The diagnosis of this condition primarily relies on cross-sectional imaging and is made most often after computed tomography. Clinically, it is most often mistaken for acute diverticulitis. Aproxiamtely 7.1% of patients investigated to exclude sigmoid diverticulitis have imaging findings of primary epiploic appendagitis.
Subramaniam R. Acute appendagitis: emergency presentation and computed tomography appearances. Emerg Med J 2006;23:e53. http://emjonline.com/cgi/content/full/23/10/e353 doi: 10.1136/emj.2005.033704.
We report an unusual case of delayed presentation of a tension faecopneumothorax after traumatic injury to the diaphragm 5 years previously. This article highlights Three important clinical lessons including: (a) for suspected tension pneumothorax, if a significant quantity of serous fluid is drained in addition to air, think of a communication with the peritoneal cavity; (b) spontaneous
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