Encapsulated Mesenteric Fat Necrosis

A 33-year-old female presented at the emergency department with a 36-hour history of peri-umbilical pain associated with anorexia and nausea. On physical examination, she was tender to palpation in the right lower quadrant. Psoas sign was absent, and there was no rebound tenderness. Laboratory examination revealed slightly elevated neutrophil count and elevated C-reactive protein. Her past medical history was unremarkable.Appendicitis was suspected and abdominal ultrasound was performed, which demonstrated an oval hyperechogenic mass with a hypo-echogenic rim in the right para-umbilical region (Figure A). There was maximal probe tenderness at that point. The appendix was not well seen. Subsequent CT showed a round, encapsulated mass with predominantly fat attenuation located in the right para-umbilical region (Figures B and C). There were no calcifications present within the mass. No enhancement was seen after intravenous contrast administration. The appendix appeared normal.These imaging findings, associated with the clinical presentation of the patient, led to the diagnosis of encapsulated mesenteric fat necrosis. Published on 2016-03-31 18:35:09
Source: Journal of the Belgian Society of Radiology - Category: Radiology Source Type: research

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