Purpose
The purpose of this study was to describe the helical abdominal CT findings of ascending retrocecal appendicitis focusing on the location, extent of inflammatory process and complications.
Methods and Materials
Patient selection We searched the medical record database of our institution for the period from August 1995 to August 2002 for patients with surgically proved acute appendicitis. We obtained a list of 33 consecutive patients of acute ascending retrocecal appendicitis who underwent contrast medium-enhanced abdominal and pelvic CT. There were 27 men and 6 women, ranging from 18 to 84 years old (mean age, 50 years). After obtaining CT examinations, the patients underwent surgical treatment immediately or within 22 days. The operative and pathologic findings...
Results
Clinical Findings Patients complained of right lower quadrant pain (n=16), right flank pain (n=8), right upper quadrant pain (n=6), periumbilical pain (n=5), and mild fever (n=6). Anorexia, nausea, vomiting, and diarrhea developed. The mean duration of the symptom was 7.4 days (one day to two months). Twenty three patients had leukocytosis (>10,000/mL). The distribution of initial diagnostic disease included acute appendicitis (n=21), diverticulitis (n=2 ), acute gastroenteritis (n=2), ureter stone (n=2), acute pyelonephritis (n=2), colon cancer (n=2), and irritable bowel syndrome (n=1). One patient developed...
Conclusion
Ascending retrocecal appendicitis were demonstrated with some atypical clinical features and unusual CT findings compared to pelvic intraperitoneal appendicitis. Characteristic CT findings of ascending retrocecal appendicitis are location of inflamed appendix in posterolateral aspect of ascending colon, abscess in retrocolic, paracolic gutter, and subhepatic space, retroperitoneal extension of inflammation associated with thickening of lateroconal, Gerotas fasciae and ascending colon. In patients in whom the clinical diagnosis is in doubt, we advocate the use of CT in the following reasons: 1) to determine a specific diagnosis...
References
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Personal Information
Sooah Kim MD, Soon Jin Lee MD, Hyo K. Lim MD, Jin Young Na MD, Dongil Choi MD,Suk Sun Kang MDDepartment ofRadiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine,Seoul, Korea