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 mm 3. Dilated non-compressible fluid filled lumen

CT Technique: 1.CT abd/pelvis without any contrast 2.Oral contrast 3.IV contrast 4.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