Pediatric Cystic Fibrosis Normal Appendix

  • Etiology: Cystic fibrosis causes distention of appendix by inspissated secretions
  • Imaging: The appendix can have a larger than normal diameter and still be normal, i.e. without acute appendicitis
  • DDX: Acute appendicitis
  • Complications:
  • Treatment:
  • Clinical: Prevalence of acute appendicitis in cystic fibrosis patients is lower than in general population

Radiology Cases of Cystic Fibrosis Normal Appendix

Radiology Cases of Cystic Fibrosis Normal Appendix and Fatty Infiltration of the Liver and Acute Pancreatitis with Pseudocyst and Chronic Pancreatitis and Distal Intestinal Obstruction Syndrome

CT of enlarged but normal appendix in cystic fibrosis
Axial CT with contrast of the abdomen (above left) shows a low density liver due to fatty infiltration and a low density pancreas with calcifications that has a round low density fluid collection near the pancreatic head. The appendix in the right lower quadrant posterior to the cecum is dilated in diameter up to 10 mm but has no periappendiceal inflammation (above right and below). There is stool mixed with air in the terminal ileum medial to the cecum (above right and below).

Radiology Cases of Cystic Fibrosis Normal Appendix and Cirrhosis of the Liver and Pancreatic Insufficiency

CT of a dilated but normal appendix in a patient with cystic fibrosis
Axial CT with contrast of the abdomen (above left) shows an irregular contour to the liver and fatty replacement in the pancreatic head. Axial (below left) and coronal (right) CT show the appendix is dilated to a diameter of 12 mm but there are no inflammatory changes around it.