Aims and objectives
Lymphoid hyperplasia can be an important mimicker by creating a non-compressible appendix more than 6 mm in diameter.
The aim of this study was to evaluate methods of distinguishing lymphoid hyperplasia and appendicitis on the basis of sonography,
lamina propria thickness and Alvarado scoring.
Methods and materials
This retrospective study included 259 patients (142 appendicitis,
117 lymphoid hyperplasia).
The US (ultrasound) reports of the patients were reviewed and the maximum diameter of the appendix,
the presence or absence of increased echogenicity of the surrounding pericaecal fat,
local fluid collection,
the presence of reactive lymph nodes in the peri-appendiceal area,
and mural hyperemia within the appendix were recorded.
The study included a total of 259 patients (142 appendicitis,
117 lymphoid hyperplasia),
comprising 128 females (49.4%,
69 in acute appendicitis group; 59 in lymphoid hyperplasia group) and 131 males (50.6%,
73 in acute appendicitis group; 58 in lymphoid hyperplasia group) with a median age of 26 years (range,
4–78 years). The use of additional sonographic criteria,
lamina propria thickness (≤ 1 mm is indicative for appendicitis) or Alvarado scoring (> 6 mm is indicative for appendicitis)...
The presence of local fluid collection in the peri-appendiceal area and a lamina propria thickness ≤ 1 mm are the most successful parameters for distinguishing appendicitis from lymphoid hyperplasia.
The diagnosis of acute appendicitis: clinical assessment versus computed tomography evaluation.
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Three-step sequential positioning algorithm during sonographic evaluation for appendicitis increases...