Acute appendicitis: paediatric

Case contributed by Dr Alborz Jahangiri


A 2 years old boy complaining of right sided back pain for 4 days.

Patient Data

Age: 2
Gender: Male
Modality: Ultrasound

The right iliac fossa was examined by graded compression ultrasound.

An enlarged appendix (>6 mm) is seen with distinct wall layers as a blind-ending filled tube arising form the medial aspect of the caecum which was not compressible.

There is also surrounding abnormal echogenic omental fat.

Ileo-caecal lymphadenopathy is also noted.

Case Discussion

Ultrasound is the investigation of choice in young patients being investigated for acute appendicitis.

Graded compression ultrasound is the technique used.

Findings to support the diagnosis are: 

  • aperistaltic, non-compressible, dilated appendix (>6 mm outer diameter)
  • target appearance
  • periappendiceal fluid collection
  • periappendiceal hyperechoic structure
  • echogenic prominent pericaecal fat
  • appendicolith
  • distinct appendiceal wall layers
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Case Information

rID: 48029
Case created: 15th Sep 2016
Last edited: 16th Sep 2016
Inclusion in quiz mode: Included

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