Appendicitis ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

Ultrasound may be helpful in the diagnosis of appendicitis. Findings that are supportive of the diagnosis of appendicitis include noncompressible, dilated appendix, appendicolith, echogenic prominent pericaecal fat and periappeniceal fluid collection.

Ultrasound

  • CT scans are preferred over ultrasounds for diagnosing appendicitis. However, ultrasound imaging presents with the least amount of radiation and is therefore the investigation of choice for young patients.[1][2][3]
  • The ultrasound technique is known as graded compression, which uses linear probes over sites of maximal thickness and gradually increasing pressure exerted to displace normal overlying bowel gas.

Findings Supportive of Appendicitis

Findings that are supportive of the diagnosis of appendicitis include:[4]

  • Aperistaltic, noncompressible, dilated appendix (>6 mm outer diameter)
  • Appendicolith
  • Distinct appendieal wall layers
  • Echogenic prominent pericaecal fat
  • Periappeniceal fluid collection
Inflammed appendix associated with perforation
Source:Case courtesy of Dr Maulik S Patel, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/26853">rID: 26853</a>

References

  1. Pinto F, Pinto A, Russo A, Coppolino F, Bracale R, Fonio P, Macarini L, Giganti M (2013). "Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature". Crit Ultrasound J. 5 Suppl 1: S2. doi:10.1186/2036-7902-5-S1-S2. PMC 3711731. PMID 23902717.
  2. Mostbeck G, Adam EJ, Nielsen MB, Claudon M, Clevert D, Nicolau C, Nyhsen C, Owens CM (2016). "How to diagnose acute appendicitis: ultrasound first". Insights Imaging. 7 (2): 255–63. doi:10.1007/s13244-016-0469-6. PMC 4805616. PMID 26883138.
  3. Hussain S, Rahman A, Abbasi T, Aziz T (2014). "Diagnostic accuracy of ultrasonography in acute appendicitis". J Ayub Med Coll Abbottabad. 26 (1): 12–7. PMID 25358207.
  4. Appendicitis. Radiopaedia.org (27 August 2015). http://radiopaedia.org/articles/appendicitis Accessed on December 7, 2015



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