DOI: https://doi.org/10.36347/sasjm.2026.v12i06.020

Pages: 681-684

Epiploic appendagitis is a rare and benign inflammatory condition that typically presents as localized acute abdominal pain and is usually managed conservatively. Complications such as abscess formation are exceptional and rarely reported. We describe the case of a 36-year-old woman who presented with a four-day history of left iliac fossa pain associated with fever. Clinical examination revealed localized tenderness without signs of peritonitis, and laboratory tests showed an inflammatory syndrome. Contrast-enhanced abdominopelvic computed tomography demonstrated a 66×51 mm pericolonic collection with fat density, internal septations, and an enhancing rim, consistent with an abscess complicating epiploic appendagitis. Despite initial treatment with intravenous antibiotics, the persistence of septic symptoms required surgical intervention, including drainage of the abscess and resection of the necrotic epiploic appendage. The postoperative course was uneventful, with complete recovery and no recurrence during follow-up. This case highlights a rare complication of epiploic appendagitis and emphasizes the key role of computed tomography in diagnosis and detection of complications. Although the condition is usually self-limiting, invasive management may be necessary in complicated cases, underscoring the importance of close clinical and radiological monitoring.