* Intraoperative findings which include Position, width, length, gross appearance including the presence of inflammation, obstruction, gangrene and perforation and presence of appendicolith
The CT findings of appendicitis include dilatation of appendix (>6 mm in diameter), heterogeneity of periappendiceal and pericecal fat as a sign of inflammation, and intraluminal appendicolith
and formation of phlegmon or abscess (1) (Figure 1).
Migration of pain, anorexia, bilious vomiting, pyrexia, guarding, rebound, positive heel drop test, gurgling, leukocytosis, neutrophilia, CRP elevation, scoliosis to the right side on X-ray, localized air-fluid level, localized gas deposition, appendicolith
, increase in appendix diameter, and wall thickness and periappendiceal free fluid rates were significantly higher in Group A (p<0.001).
The migration of an appendicolith
(dense mixture of stool and mineral deposit) from the abdomen to the thorax can also initiate an infection later in this compartment .
According to the US report, cases with a thickness of more than 6 mm, no peristalsis, compression anechoic fluid collection, appendicolith
, and US McBurney findings were accepted as US-positive.
Ultrasound criteria include a diameter greater than 6 mm, concentric rings (target sign), an appendicolith
, high echogenicity, obstruction of the lumen, and fluid surrounding the appendix.
These findings were non-compressibility (83%), appendicular tube (55%), appendicolith
(13%), omental thickening (80.5%), surrounding free fluid (63.8%), and the probe tenderness (91.7%).
Caption: FIGURE 1: Axial section of abdominal CT scan with contrast demonstrating swollen appendix with 9.8 mm diameter, no appendicolith
Involvement of the right psoas muscle (thick black arrow) as well as the presence of an appendicolith
(thin black arrow) is demonstrated.
Until recently, the presence of an appendicolith
was considered 100% specific for the diagnosis of acute appendicitis.
On ultrasound imaging, a distended non-compressible appendix was present, containing an appendicolith
Occasionally, a plain abdominal radiograph can show signs of obstruction, perforation, foreign bodies and, in rare cases, an appendicolith
, which is a hardened stool in the appendix.