Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10242
Peer-review started: January 15, 2014
First decision: January 22, 2015
Revised: February 5, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: September 21, 2015
Unspecific abdominal complaints including bloating and irregular bowel movements may be caused by carbohydrate malabsorption syndromes, e.g., lactose and fructose malabsorption. These symptoms were investigated with hydrogen (H2) breath tests and correlated to carbohydrate malabsorption. During performing these H2-breath tests the patient presented with an acute, localized, non-migratory pain in the left lower abdominal quadrant. Primary epiploic appendagitis is a rare cause of abdominal acute or subacute complaints and diagnosis of primary epiploic appendagitis (PEA) is made when computed tomography reveals a characteristic lesion. We report on a patient with co-occurrence of lactose and fructose malabsorption, which was treated successfully with a diet free of culprit carbohydrates, with PEA recovering without medication or surgical treatment within few days. Since the abdominal unspecific symptoms had been present for months, they appeared not to be correlated to the acute localized abdominal pain, therefore we speculate on a random co-occurrence of combined carbohydrate malabsorption and PEA.
Core tip: The symptoms of unspecific abdominal complaints were investigated with hydrogen breath tests and correlated to lactose and fructose malabsorption. During performing these H2-breath tests the patient presented with an acute abdominal pain. Primary epiploic appendagitis (PEA) is a rare cause of abdominal acute complaints and diagnosis of PEA is made when computed tomography reveals a characteristic lesion. Since the abdominal unspecific symptoms had been present for months, they appeared not to be correlated to the acute localized abdominal pain, therefore we speculate on a random co-occurrence of combined carbohydrate malabsorption and PEA.