Acute appendicitis
Monday 05 October 2009, Rudolf Králik, M.D. and Branislav Kunčak, M. D.
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Ultrasonography in the diagnosis of acute appendicitis
Graded compression technique- gentle pressure applied in right lower quadrant of the abdomen by tranducer allows for the evaluation of inflamed appendix. Normal and gas filled loops of gut are either pushed away or compressed while inflamed noncompressible appendix is well seen.
Features of acute appendicitis at ultrasonography
Inflamed appendix is seen as a blind-ended, noncopressible and aperistaltic tubular structure arising from the base of the caecum. Its diameter should be more than 6mm.
Ovoid shape of the appendix in transverse section over its entire length is an evidence against the diagnosis of acute appendicitis.
On the other hand, presence of an appendicoliths (they appaear as echogenic structures with acoustic shadowing) and increase echogenicity of periappendiceal fat support the diagnosis.
Color doppler imaging shows circumferential flow in the wall of inflamed appendix.
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