A Rare Presentation of Epiploic Appendagitis as Chest Pain: A Case Report

TL;DR

A rare case of epiploic appendagitis presented as chest pain, highlighting the condition's unusual symptoms and potential for misdiagnosis.

Contribution

This case report presents a rare instance of epiploic appendagitis manifesting as chest pain.

Findings

The patient presented with chest pain, but physical examination revealed right upper quadrant tenderness.

Imaging confirmed epiploic appendagitis, and the patient improved with conservative management.

The atypical presentation may be due to proximity to chest-related organs or inaccurate pain localization.

Abstract

Epiploic appendagitis (EA) is an ischemic infarction of an epiploic appendage due to torsion or spontaneous thrombosis of the central vein of an epiploic appendage. It is a rare but benign and self-limiting cause of abdominal pain that is often misdiagnosed. The typical presentation of EA is lower abdominal pain, but pain can also occur in other parts of the abdomen. Presentation outside of the abdomen is a rare occurrence. Our patient presented with chest pain, and it was only through physical examination that mild right upper quadrant tenderness led to the suspicion of an intra-abdominal pathology, which was then confirmed with imaging. The patient responded to conservative management. Our possible explanation for this occurrence includes the proximity of the inflamed appendage to organs associated with chest pain and the possibility that patients sometimes describe pain location inaccurately.

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