Acute appendicitis with CT arrowhead sign

Case contributed by Dr Bita Abbasi


RLQ pain and tenderness.

Patient Data

Age: 20 years
Gender: Male

Dilatation of appendix and periappanciceal mesentric fat strandings with an appendicolith in the appendiceal lumen. Mesentric lymphadenopathy is distinguishable in the adjacent mesentric fat.
Inflammation at the base of the appendix produces an 'arrow like' collection of caecal contrast.

Case Discussion

Acute appendicitis is one of the commonest causes of an ‘‘acute abdomen’’ and appendicectomy is the commonest emergency surgical operation performed worldwide.
The two diagnostic CT signs of acute appendicitis are unequivocal identification of an abnormalappendix, which is usually fluid-filled with a slightly thickened and circumferentially enhancing wall and dilated more than 6 mmin transverse diameter, or an appendicolith associated
with pericaecal inflammatory stranding.

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Case information

rID: 21474
Published: 25th Jan 2013
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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