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
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Computed tomography of the normal appendix and acute appendicitis.
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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...