From the Research
The initial management approach for epiploic appendagitis is conservative treatment with pain control using nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen 400-600 mg every 6-8 hours or naproxen 500 mg twice daily for 5-7 days. This condition is a self-limiting inflammatory process involving the epiploic appendages of the colon and typically resolves spontaneously within 1-2 weeks without specific intervention 1. The diagnosis of epiploic appendagitis primarily relies on imaging modalities such as CT, which can help differentiate it from other causes of acute abdominal pain like diverticulitis or appendicitis 2.
Some key points to consider in the management of epiploic appendagitis include:
- Antibiotics are not necessary as this is not an infectious process 3
- Patients should be advised to rest as needed and maintain adequate hydration
- Follow-up is recommended if symptoms worsen or fail to improve within a week
- Surgery is rarely indicated and should be reserved only for complications such as abscess formation, intestinal obstruction, or peritonitis, which are extremely uncommon 4
The conservative approach is justified because epiploic appendagitis is benign and self-resolving; unnecessary surgical intervention or antibiotic use would expose patients to potential risks without providing additional benefit 5. It is essential to consider epiploic appendagitis as one of the differential diagnoses for acute lower abdominal pain to avoid unnecessary hospitalization and surgical intervention 2.