Differentiating Right-sided Epiploic Appendagitis From Diverticulitis

Differentiating Right-sided Epiploic Appendagitis From Diverticulitis: A Retrospective Analysis of Clinical Presentation, Imaging Characteristics, and Outcomes

This study will perform a retrospective analysis of adult patients who presented to the emergency department of National Taiwan University Hospital, Hsin-Chu and Yun-Lin Branches between January 2022 and December 2025 and were diagnosed with either right-sided epiploic appendagitis or right-sided colonic diverticulitis based on CT findings. Clinical presentations, laboratory data, ultrasound and CT imaging characteristics, treatment strategies, and clinical outcomes will be compared between the two groups. The study aims to identify imaging and clinical features that may facilitate the rapid differentiation of these two conditions in the emergency department.

Right-sided epiploic appendagitis and right-sided colonic diverticulitis are common differential diagnoses in patients presenting with right lower quadrant abdominal pain in the emergency department. Because the two conditions share many similar clinical manifestations, misdiagnosis is common. Epiploic appendagitis is a benign and self-limiting disease; however, when misdiagnosed as diverticulitis, it may lead to unnecessary hospitalization, antibiotic treatment, or even surgical intervention, resulting in increased healthcare utilization and patient burden. Although computed tomography (CT) is currently considered the gold standard for diagnosing both conditions, identifying distinguishing clinical features may facilitate accurate diagnosis and appropriate management.

This study will perform a retrospective analysis of adult patients who presented to the emergency department of National Taiwan University Hospital, Hsin-Chu and Yun-Lin Branches between January 2022 and December 2025 and were diagnosed with either right-sided epiploic appendagitis or right-sided colonic diverticulitis based on CT findings. Clinical presentations, laboratory data, ultrasound and CT imaging characteristics, treatment strategies, and clinical outcomes will be compared between the two groups. The study aims to identify imaging and clinical features that may facilitate the rapid differentiation of these two conditions in the emergency department.

Inclusion Criteria:

• patients more than 20 years, with CT-confirmed right-sided epiploic appendagitis

Exclusion Criteria:

• patients less than 20 years with other abdominal pathologies