Although its wall was slightly prominent, there were no surrounding inflammatory changes and there was no appendicolith
was also present at the base of the appendix (Figure 1b).
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
Pathologic examination of the appendix revealed a thickened wall with an appendicolith
and pinworms, but no frank infection.
Positive findings of appendicitis include an outer diameter greater than 6 mm, a noncompressible lumen arising from the base of the cecum, echogenic periappendiceal inflammatory fat changes, an appendicolith
or a periappendiceal fluid collection (Figures 6 and 7).
There was also an atrophic left kidney but no evidence of lymphadenopathy, (some of the images were degraded by artefact from a DHS fixation of the left hip), and no evidence of bowel obstruction or appendicolith
A more remote CT scan of the abdomen and pelvis performed approximately 29 months before revealed appendicitis with an associated appendicolith
2 cm appendicolith
was present within the appendiceal lumen.
In a review of 380 patients, Shindoh et al reported that the presence of an appendicolith
correlated with negative outcome in nonoperative management.
Ultrasound Findings for Acute Appendicitis * Non compression * Blind ending * Tubular structure >6 mm in diameter * Appendicolith
* Mesenteric stranding * Free fluid Table 10.
USD signs of acute appendicitis are a noncompressible appendix >6 mm in diameter measured from outer wall to outer wall, and visualization of a shadowing appendicolith