Acute appendicitis: Importance of early detection with multidetector CT

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-0070

Type:

Educational Exhibit

Keywords:

Inflammation, Infection, Acute, Diagnostic procedure, CT, Gastrointestinal tract, Emergency, Abdomen

Authors:

M. E. Hjelt, D. C. Santoro, D. E. Garzon, D. E. Pizarro, M. schneider, J. F. Rios, C. D. Olmedo Plata, A. E. Buzzi; Buenos Aires/AR

DOI:

10.1594/ecr2015/C-0070

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-0070

Fig. 2: Normal Appendix

Fig. 5: Retroceacal appendicitis with fat stranding

Fig. 9: Coronal View. Distended retroceacal intrapelvic appendix with fat stranding.

Fig. 10: Thikened appendix wall

Fig. 7: Appendicolith and fat stranding

Fig. 11: Sagital MIP reconstruction. Thikening of the caecum base, thikened appendix and...

Learning objectives

The purpose of this exhibit is to review and illustrate early CT findings in acute appendicitis. The radical importance ofearly detection of acute appendicitis is that it reduces drastically complications(perforation, abscess, etc)and morbility. We will also describe CT procedure,appendix anatomy, clinical findings, CT findings and differential diagnoses.

Background

In the western world appendicitis is the most common cause of acute abdominal pain that requires surgical intervention. The primary pathogenic event is obstruction caused by appendicolith and lymphoid hiperplasia. Other causes include foreign bodies, parasites, tumors, etc. When obstruction occurs, the continued secretion of mucus results in elevated intraluminal pressure and distention, with venous engorgement, arterial compromise and tissue ischemia. Luminal bacteria multiply and invade the wall causing inflammation. Aproximatelly 50% of patients with acute appendicitis present with classic signs and symtoms. Atypical presentations...

Findings and procedure details

CT Protocol CT was performed on an 128 channel (Somatom Perspective) multidetecto CT scanner. Acquisition of thin sections covering the abdomen and pelvis from the dome of the diaphragms through the pubic simphysis were aquired in a single breath hold. Oral contrast was administered if the patients condition allowed. Normal Anatomy The appendix is a tubular like structure (veriform) whose mean length is about 6 to 8cm in adults and 2 to 15cm in children. Its mean diameter is 7mm. Fig. 2 The wall measures...

Conclusion

Multidetector CT is the modality of choice in detection of early acute appendicitis with atipical presentations,reducing drastically complications and morbility. Its a noninvasive and quik method.

Personal information

Marcos E. Hjelt(Buenos Aires/AR) [email protected] CT and MRI Division. Diagnostico Tesla Ntra. Sra. del Buen Viaje 548 (CP1708) Moron. Buenos Aires. Argentina

References

Platon A, et al. Evaluation of a low-dose CT protocol with oral contrast for assesment of acute appendicitis. Eur Radiol (2009) 19:446-454. Ghiatas A, et al. Computed tomography of the normal appendix and acute appendicitis. Eur Radiol (1997) 7:1043-1047. Pickhardt P, et al. Appendiceal length as an independent risk factor for acute appendicitis. Eur Radiol (2013) 23:3311-3317. Tamburrini S, et al. Ct appearance of the normal appendix in adults. Eur Radiol (2005) 15:2096-2103. Jang SO, et al. Application of Alvarado score in patients with suspected...