perigastric appendagitis

Perigastric appendagitis is a rare inflammatory/ischemic process involving the perigastric ligaments (gastrohepatic, gastrosplenic and falciform ligaments).

Along with epiploic appendagitis and omental infarction, perigastric appendagitis falls under the umbrella of intraperitoneal focal fat infarction, with each entity having similar underlying mechanisms and radiological appearances, and mimicking other acute abdominal diseases.

Clinical presentation

Acute and severe abdominal (epigastric) pain in absence of fever.

Pathology

Peritoneal ligaments contain uneven quantities of extraperitoneal fat.

Similar to epiploic appendagitis and omental infarction, perigastric appendagitis occurs when perigastric ligament appendages spontaneously twist causing vascular compromise and infarction.

Radiographic features

CT

Oval heterogeneous fat density focus with mild surrounding fat stranding along the course of the gastrohepatic (anterior to the stomach), gastrosplenic (posterior to the stomach), and falciform (anterior to the liver) ligaments.

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