Teenager with right lower quadrant pain and WBC=30,000

US of acute appendicitis with appendicolith
Sagittal US of the right lower quadrant (above) shows a dilated, non-compressible, blind ending tubular structure measuring 10 mm in diameter with an echogenic focus at its tip causing posterior shadowing. Transverse US of the cecum (below) shows it to be thickened in appearance.

The diagnosis was acute appendicitis with an appendicolith at the tip of the appendix. In the operating room, the inflammed appendix was adherent to an inflamed cecum.