Acute Appendicitis
Understanding Acute Appendicitis found on Right Lower Quadrant Computed Tomography imaging. Learn what this finding means and what steps to take next.
Radiographic Appearance
Computed Tomography FindingDilated appendix (>6 mm) with wall thickening and peri-appendiceal fat stranding.
Clinical Significance
Common surgical emergency; untreated rupture can cause peritonitis.
What is Acute Appendicitis?
Inflammation of the vermiform appendix, usually from luminal obstruction. CT is highly sensitive for confirmation.
Imaging Appearance
- Tubular blind-ending structure ＞6 mm diameter
- Wall enhancement/thickening
- Peri-appendiceal fat stranding or phlegmon
- Possible appendicolith; free fluid or gas suggests perforation
Clinical Significance
- Delay increases risk of perforation and abscess
- Typical symptoms: RLQ pain, fever, nausea, anorexia
- Differential: mesenteric adenitis, Crohn's ileitis, gynecologic causes
Symptoms
- Periumbilical pain migrating to RLQ
- Low-grade fever
- Rebound tenderness
Diagnosis
- CT abdomen/pelvis with IV contrast is preferred
- Ultrasound first in children/pregnancy; MRI if ultrasound equivocal
- Labs: elevated WBC/CRP; rule out pregnancy in females
Treatment
- Early appendectomy (laparoscopic)
- Antibiotics for perioperative coverage; selected nonperforated cases may try antibiotics-first
Prognosis
- Excellent with early surgery; perforation increases morbidity
What Should You Do?
- Seek urgent surgical evaluation.
- NPO and start IV fluids/antibiotics as directed.
- Monitor for worsening pain, fever, or diffuse tenderness.
Related Imaging Terms
- Bowel Obstruction - downstream complication if perforation causes ileus.
- Pneumonia Consolidation - alternate cause of fever/right-sided pain in some patients.
Common Questions
Can appendicitis resolve without surgery?
Rarely. Most require appendectomy; antibiotics-only has recurrence risk.
Is CT safe?
CT uses radiation; risk is outweighed by diagnostic accuracy in suspected appendicitis.
Medical Disclaimer: Educational only; follow your surgeon's advice.
Correlate with Lab Results
Doctors often check these blood tests when Acute Appendicitis is found on imaging:
Related Imaging Terms
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