Primary epiploic appendagitis mimicking acute abdomen in emergency department

A 27-year-old man presented to the emergency department of our institution with left lower quadrant pain that started 8 h ago. He did not describe kidney stone, chronic medical problem, or recent trauma in his anamnesis. His vital signs were stable, but physical examination revealed defense and rebond in the left lower quadrant. Laboratory findings were unremarkable except for mildly elevated C-reactive protein (CRP) levels of 6.28 mg/L (reference value: 0–5 mg/L). He was referred to abdominal ultrasonography (USG) following laboratory tests and his written informed consent was obtained before imaging studies. Solid organs were in normal limits in USG, but a significantly increased echogenicity was noted in the pericolic fat tissue adjacent to the sigmoid colon surrounded by a hypoechoic border, which was suspicious for sigmoid diverticulitis