Imaging of acute appendicitis and it’s complications

Imaging modalities

• Plain films• US• CT

Plain films

• Calcified appendicolith• Focal ileus

US diagnosis of appendicitis

• Compression US technique.1. An appendix diameter of > 6 mm 2. Wall thickness of > 3 mm3. Dilated non-compressible fluid filled lumen

CT

• Technique:1.CT abd/pelvis without any contrast2.Oral contrast3.IV contrast4.Rectal contrast

CT Findings in Acute Appendicitis

• Normal appendix• Appendicolith (Presence of appendicolith and abdominal pain has

a sensitivity of 90% for acute appendicitis)

• Enlarged appendix, 7-10 mm (Previously 6 mm)

• Peri-appendicular inflammation-linear streaky densities in peri-appendicular fat

• Abscess

Excess abdominal fat is a good thing!!

Mildly dilated appendix with fluid filled lumen

Enlarged and inflamed appendix with wall thickening and peri-appendiceal inflammation

Appendicitis and pelvic abscess.

Per-cutaneous drainage of appendiceal abscess