This is a common surgical emergency that is slightly more common in teenaged/young adult males. PLAIN FILM • Cecal wall thickening. • Sm...
This is a common surgical emergency that is slightly more common in teenaged/young adult males.
PLAIN FILM
• Cecal wall thickening.
• Small bowel dilatation.
• Focal extraluminal gas.
• Rarely, a faecolith is visible.
US
• Frequently used to investigate complicated appendicitis (e.g. abscess) or alternative diagnoses (e.g. ovarian cyst).• Look for an appendix with diameter of >6 mm and wall thickness >2 mm.• Findings to suggest perforation: fluid collection adjacent to the appendix, gas bubbles near the appendix and loss of visualisation of the submucosal layer.
CT
• Dilated, thick-walled appendix.• Inflammatory fat stranding.• Rim-enhancing fluid collection (i.e. abscess).• Peri-appendiceal gas locules (localised perforation).• Small bowel dilatation.• Note—in patients >50 years of age, consider appendix mucocele (can be benign or malignant); wall calcification is specific but not sensitive for this.
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