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Imaging findings of perforative appendicitis: a pictorial review
K L Hopkins1, L E Patrick, T I Ball
1Emory University School of Medicine, Department of Radiology, Children's Healthcare of Atlanta at Egleston, GA 30322, USA. khopkin@emory.edu
Insights
Pediatric appendicitis diagnosis can be challenging, leading to a high rate of perforation. This review highlights key imaging findings for complications like abscesses and peritonitis, aiding early detection in children.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
- Abdominal Imaging
Background:
- Appendicitis is a frequent pediatric surgical emergency.
- Classic diagnostic signs may be subtle or absent in children, increasing perforation risk.
- Perforated appendicitis can lead to serious abdominopelvic complications.
Purpose of the Study:
- To review imaging findings of appendicitis complications in children.
- To emphasize the role of CT and sonography in diagnosing sequelae.
- To discuss secondary involvement of other organ systems.
Main Methods:
- Review of imaging findings in pediatric appendicitis.
- Focus on computed tomography (CT) and ultrasonography (US).
- Analysis of complications such as abscess, peritonitis, and vascular involvement.
Main Results:
- Imaging demonstrates characteristic sequelae of perforated appendicitis.
- CT and sonography are crucial for identifying abdominopelvic abscess, peritonitis, pyelephlebitis, pyelethrombosis, and hepatic abscess.
- Secondary urinary and gastrointestinal tract involvement is frequently observed.
Conclusions:
- Radiological imaging, particularly CT and sonography, is essential for diagnosing appendicitis complications in children.
- Early recognition of imaging findings can guide timely intervention and improve outcomes.
- Understanding secondary organ involvement aids comprehensive patient management.
Abstract:
Appendicitis is common in children. Early diagnosis depends on recognition of characteristic signs and symptoms: right lower quadrant or periumbilical pain, localized tenderness, fever, and leukocytosis. Because these classic features may be difficult to elicit or masked by other complaints, the incidence of perforative appendicitis in children is high. This paper reviews the imaging sequelae with emphasis on CT and sonography findings. Areas of focus include abdominopelvic abscess, peritonitis, pyelephlebitis, pyelethrombosis, and hepatic abscess. Secondary involvement of the urinary and gastrointestinal tracts is also discussed.