Summary

A 25-year-old female presented to the emergency department (ED) with a 1-day history of crampy left iliac fossa (LIF) abdominal pain. It was associated with both nausea and vomiting. On examination she was tender in the LIF with some guarding. Her observations were satisfactory and she was apyrexial. Urine dipstick and pregnancy stick were negative. The case was a diagnostic quandary. On ultrasound scan (USS) no acute gynaecological problems were found. Computed tomography (CT) of the abdomen showed epiploic appendagitis. This was managed conservatively with analgesia and antibiotics and the patient was discharged home pain free. She was followed up in the general surgical clinic 1 week later where she continued to be symptom free. She was discharged from general surgical care.