（右下腹部痛シリーズExpertコースRE７の解答より）腹膜垂炎の造影CT所見は（下記文献），１)1〜4cm大の，卵円型の，正常の脂肪よりdensityの高い，さらにhigh densityの外縁を伴った，大腸壁に接する脂肪組織（図６と図７：▲），２)隣接する大腸は部分的に壁肥厚を呈し(図４と図５：△)，その壁肥厚した大腸の範囲は5cm以内で（図A：↑），３)周囲脂肪組織の炎症性浮腫（白矢印）や腹膜の肥厚（↑）があることである．憩室炎と診断され4日間の抗生物質投与で治癒したが，第7病日に行った注腸造影（図A）にて憩室を認めず，部分的な圧排像を呈し腹膜垂炎（epiploic appendagitis）を強く示唆する．

文献考察
1)Legome EL, Belton AL, Murray RE, Rao PM, Novelline RA.
Epiploic appendagitis: the emergency department presentation.
J Emerg Med. 2002 Jan;22(1):9-13.

We performed a structured retrospective chart review to describe clinical characteristics of Emergency Department (ED) patients diagnosed by history, physical examination, and abdominal computed tomography (CT) scan with epiploic appendagitis (EA). EA is a disease caused by inflammation of the appendix epiploica, subserosal adipose tissue along the colon. It may mimic surgical causes of acute abdominal pain, but is treated conservatively with pain management. There were 19 patients diagnosed with EA, with follow-up performed on 85%. All had focal, nonmigratory symptoms. Common findings included left lower quadrant pain and guarding, and a normal temperature and white cell count. No patient required operation. This preliminary work characterizes some common clinical features of ED patients diagnosed with EA. As use of emergency CT scan for abdominal pain increases, clinicians will encounter this more often. These features should also prompt the clinician to consider CT scan in patients with similar signs and symptoms. Accurate diagnosis may avoid unnecessary surgery. PMID: 11809550 [PubMed - indexed for MEDLINE]

2)van Breda Vriesman AC, Puylaert JB.
Epiploic appendagitis and omental infarction: pitfalls and look-alikes
Abdom Imaging. 2002 Jan-Feb;27(1):20-8.

Epiploic appendagitis and omental infarction are benign self-limiting conditions that are more frequent than generally assumed. Both disorders frequently mimic symptoms of an abdominal surgical emergency, often leading to clinical misdiagnosis of appendicitis or diverticulitis. Because a misdiagnosis can result in an unnecessary laparotomy, a correct diagnosis is of great importance. Ultrasound and computed tomography can be used to make a reliable diagnosis. This pictorial essay illustrates the various ultrasonographic and computed tomographic appearances of epiploic appendagitis and omental infarction and focuses on their radiologic differential diagnoses and pitfalls. PMID: 11740602 [PubMed - indexed for MEDLINE].

3)Sirvanci M, Tekelioglu MH, Duran C, Yardimci H, Onat L, Ozer K.
Primary epiploic appendagitis: CT manifestations.
Clin Imaging. 2000 Nov-Dec;24(6):357-61.

Inflammation of an epiploic appendage is considered to be a rare cause of acute abdomen. Recently, it has been reported that typical computed tomography (CT) findings of primary epiploic appendagitis (PEA) provide a definitive diagnosis in most of the cases. However, since these papers are only few, they are easily overlooked by the practicing radiologists. Our purpose is to add four new cases to the existing literature and to perform a review of the literature.