Presentation
Right iliac fossa pain and vomiting for 8 hours.
Patient Data
Distended inflamed appendix (11 mm in diameter) with surrounding fat stranding.
Sub-centimetric prominent surrounding lymph nodes.
No abnormal collection or abscess formation.
No free air in the peritoneal cavity to suggest bowel perforation.
Case Discussion
Unfortunately the radiologist failed to detect the inflamed appendix with ultra-sonography and the clinician then requested for CT.
CT has a high sensitivity and specificity in the detection of acute appendicitis. However, there are radiation dose consequences to bear in mind, especially in young children.