On CT abdomen with oral and IV contrast, 'mesenteric fat stranding' with thickened mesenteric vessels in a patient with acute right iliac fossa pain is MOST suggestive of:

• A Mesenteric lymphadenitis
• B Omental infarction
• C Epiploic appendagitis
• D Acute appendicitis ✓

Explanation

In acute appendicitis, periappendiceal fat stranding on CT reflects peri-appendiceal inflammation; combined with a distended (>6 mm), non-compressible appendix with wall thickening and enhancement, it is diagnostic. Mesenteric lymphadenitis shows enlarged lymph nodes with minimal fat stranding and a normal appendix. Epiploic appendagitis shows an ovoid fatty lesion with a hyperdense ring adjacent to the colon. Omental infarction shows a large fatty mass with surrounding inflammation.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.