appendictisDX mainly clinical*

US/CT

Appendicolith

Thick walled blind ending loop >6 mm

Appendix mass/abscess

Ischemic colitis

Acute ischemia rare

Hemorrhage & edema-thumbprint

Air In portal vein

Air In the wall of bowel

Chronic ischemia

Stricture

Between the splenic

flexure & sigmoid colon

Smooth

tapered

sacculation

Pneumatosis coli

DDx hemorrhage/edema

colitis

May cause silent

pneumoperitoneum

volvolus

Twisting of a loop on its mesentery

Sigmoid commonest-less in the cecum

DX usually by plain abdomenMarked dilatation of the loop; dilatation

proximally

BE DX smooth tapered narrowing non operative reduction

intussusceptions

Commonest ileo-colic Invagination of one loop into anotherUS: DX abdominal mass with hyperechoic

center

Early-no sign of peritonitis:

Pneumatic reduction- Enema with CO2/air

Barium enema for dx & reduction