Tip appendicitis

Case contributed by Dr Maulik S Patel

Presentation

Right sided abdominal pain and diarrhoea. Treated for colitis for 5 days.

Patient Data

Age: about 12 yrs
Gender: Male
Modality: Ultrasound

APPENDIX is visualized in its entire length. The distal part of it is non-compressible with a maximum outer to outer wall diameter of 9 mm. It is medial to iliac vessels, directed into the pelvis.

Its gut signature sign is preserved. Lumen is filled with echoes.

No fecolith is seen. No breach in wall is seen.

Proximal part of appendix shows normal diameter and compressibility.

Caecum shows normal wall thickness. Terminal ilium is normal.

No free fluid / lymphadenopathy is noted in right iliac fossa. 

Case Discussion

Tip appendicitis / terminal appendicitis is one of the cause for false negative ultrasound study in case of appendicitis.

Pelvic appendicitis may cause diarrhoea as in this case.

Laparoscopy done. Pus in terminal appendix.

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Case Information

rID: 24326
Case created: 7th Aug 2013
Last edited: 18th Dec 2015
Inclusion in quiz mode: Included

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