Imaging of acute

appendicitis and its

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