Corpus: Epiploic appendix
from Latin: appendix - appendage, addition; Greek: epiploon - network
Synonyms: epiploic appendages, omental appendix
1. Definition
The epiploic appendages are small, fat-filled structures, typically ranging from 0.5 to 5 cm in size, that are covered with visceral peritoneum. These appendages are found along the cecum and colon.
2. History
The epiploic appendages were first described in 1543 by Andreas Vesalius (1514-1564) without attributing any significant surgical importance to them. Later, in 1853, Rudolf Virchow (1821-1902) suggested that the separation of these appendices could potentially lead to the formation of free intraperitoneal bodies.[1][2]
3. Anatomy
The epiploic appendages are zip-shaped projections of subserosal connective tissue filled with fat. Up to 100 to 150 of these fatty tissue appendices can occur. They are more commonly found in the transverse and sigmoid colon, typically arising in two rows along the free and imental taeni of the colon. In contrast, only one row of epiploic appendages is present in the transverse colon. The rectum has no taeni, and therefore no epiploic appendices.[3]
The epiploic appendages run parallel to the outer surface of the three longitudinal bands of muscle reinforcement known as the Taeniae coli. Each epiploic appendage is supplied by one or two arterioles and venules from the respective stromal area of the colon.[1]
In newborns, the epiploic appendages are free of fat. However, in obese individuals, these appendages and the mesenteries can accumulate significant amounts of fatty tissue. In males, this fat accumulation is often responsible for the so-called "little belly".[4]
4. Physiology
The epiploic appendages contain small arterial and venous branches that help supply the corresponding segments of the colon. Additionally, they play a role in maintaining the capillarity of the abdominal cavity, particularly during the movement of the colonic wall protrusions.[5]
5. Clinic
Occasionally, torsion and infarction of an epiploic appendix can occur, a condition known as epiploic appendagitis. This condition is considered a differential diagnosis for "typical" appendicitis, as it can present with similar symptoms.
6. Sources
- ↑ 1,0 1,1 Sand et al Epiploic appendagitis - clinical characteristics of an uncommon surgical diagnosis BMC Surgery 2007
- ↑ Vinson Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review J Emerg Med 1999
- ↑ Kindermann Dissertation - Sonographic diagnosis and clinical acceptance of fatty rump infarction (appendagitis epiploica), 2018
- ↑ Frick et al, Spezielle Anatomie II, Georg Thieme Verlag, 1992
- ↑ Graumann W, CompactLehrbuch Anatomie, 3rd, Schattauer Verlag, 2004
7. Literature
- Bender et al Epiploic Appendagitis - Appendicitis epiploica: benign differential diagnosis of acute abdomen RöFo 2012
- Waldeyer et al, Human Anatomy: Textbook and atlas in one volume, 19th totaly rev. ed., De Gruyter, 2012