Intestinal obstruction secondary to torsion of an appendix epiploica: a case report

INTRODUCTION: Appendices epiploicae are affected by spontaneous torsion, calcification, primary or secondary inflammation, enlargement by lipomas or metastases and incarceration in hernias. CASE PRESENTATION: A 20-year-old Asian man was admitted with non-specific abdominal pain, which later evolved to intestinal obstruction. Operative findings showed the small bowel obstruction was due to an omental band adhered to a nodule. Histopathology of the nodule revealed an infarcted appendix epiploica. CONCLUSION: Heightened suspicion and increased awareness of this entity would have led to an earlier diagnosis. Acute torsion of an appendage usually manifests as localised abdominal pain in one of the lower quadrants. Untreated, peritonitis or intestinal obstruction may result. Use of diagnostic laparoscopy in non-resolving abdominal pain would help to resolve the issue at an earlier stage and prevent additional morbidity.