Dissimilar Pain of Primary Epiploic Appendagitis
and Malabsorption
Published: February 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/23434.9439
Wolfgang J Schnedl, Dietmar Enko, Sandra J Wallner-Li ebmann, Sonja Lackner, Harald Mangge
1. Professor, Practice for General Internal Medicine, Bruck, Styria, Austria.
2. Resident, Institute of Laboratory Medicine, Steyr, Upper Austria, Austria.
3. Associate Professor, Institute of Pathophysiology, Centre for Molecular Medicine, Medical University Graz, Graz, Styria, Austria.
4. Research Assistant, Institute of Pathophysiology, Centre for Molecular Medicine, Medical University Graz, Graz, Styria, Austria.
5. Professor, Clinical Institute of Medical and Laboratory Diagnostics, Medical University of Graz, Graz, Styria, Austria.
Correspondence Address :
Dr. Wolfgang J Schnedl,
Theodor Koernerstrasse 19b, 8600 Bruck, Styria, Austria.
E-mail: w.schnedl@dr-schnedl.at
Abstract
Primary Epiploic Appendagitis (PEA) is a rare cause of acute or subacute abdominal complaints and non-migratory pain. Usually the diagnosis of PEA is made when Computed Tomography (CT) reveals characteristic figures. Nonspecific abdominal complaints including diffuse abdominal pain may be caused by carbohydrate and/or protein malabsorption. We report a case of a patient with PEA who recovered without medication or surgical treatment within a few days. Eight months later, he was diagnosed with lactose- and histamine malabsorption and Helicobacter pylori infection. The malabsorption was treated successfully with an individually-tailored diet free of culprit triggers and the Helicobacter pylori infection was eradicated. A localized non-migratory abdominal pain caused by PEA needs to be differentiated from nonspecific abdominal complaints due to malabsorption and Helicobacter pylori infection.
Keywords
Abdominal pain, Computed tomography, Diamine oxidase, Histamine, Lactose