Appendicitis

  • Etiology: inflammation of appendix due to obstruction of appendiceal lumen
  • AXR: appendicolith in 15%, may have distal small bowel obstruction
  • US: noncompressible, blind ending tubular structure, diameter > 8 mm (diameter 6-8 mm is indeterminate), hypervascular, periappendicial fluid / abscess are signs of perforation
  • CT: diameter > 8 mm (diameter 6-8 mm is indeterminate), enhancing, appendicolith in 30%, periappendiceal fat stranding, periappendiceal fluid / abscess are signs of perforation

Cases of Appendicitis

CT of perforated appendicitis
AP radiograph of the right femur was unremarkable. Coronal STIR MRI of the right hip and femur was unremarkable aside from incidental bright pelvic free fluid noted just above the bladder. Coronal 2D reconstruction from a CT with IV and oral contrast of the abdomen shows a large complex fluid collection containing air and a central calcification in the right lower quadrant which was lying next to the psoas muscle.
CXR of Morgagni Hernia that contained acute appendicitis
CXR PA shows the right heart border to be obscured and the lateral shows loops of bowel rising above the diaphragm anterior to the heart.
AXR of small bowel obstruction due to perforated appendicitis
AXR supine (left) shows multiple dilated loops of small bowel that have air fluid levels on the AXR upright (right). There is also a suggestion of a soft tissue mass in the right lower quadrant which is displacing the bowel loops medially.
AXR of appendicolith
AXR AP shows an oval-shaped calcification in the right lower quadrant just above the right iliac crest at the level of the L4 vertebral body.
Pathologic image of acute appendicitis with appendicoliths
Pathological image with the appendix opened longitudinally shows it to be grossly inflamed with two appendicoliths within the lumen of the appendix.