Appendicitis: spectrum of appearances on helical CT

Area of Science:

• Radiology
• Medical Imaging
• Gastrointestinal Diseases

Background:

• Acute appendicitis is a common surgical emergency with diverse clinical manifestations.
• Delayed diagnosis of appendicitis can lead to serious complications such as perforation and abscess formation.
• Accurate and timely diagnosis is crucial for effective patient management.

Purpose of the Study:

• To illustrate the wide range of radiological signs and appearances of acute appendicitis on helical computed tomography (CT).
• To enhance the recognition of appendicitis on helical CT, particularly subtle or unusual presentations.
• To serve as a pictorial reference for radiologists and clinicians interpreting helical CT scans for suspected appendicitis.

Main Methods:

• This is a pictorial review based on helical CT findings in patients with pathologically confirmed acute appendicitis.
• The review includes a spectrum of appendicitis appearances, from typical to atypical.
• Radiological signs and characteristic CT features are presented and discussed.

Main Results:

• Helical CT demonstrates a variety of signs suggestive of appendicitis, which can be easily missed.
• Key findings include appendiceal wall thickening, periappendiceal fat stranding, appendicolith, and abscess formation.
• Atypical CT appearances can mimic other intra-abdominal pathologies.

Conclusions:

• Helical CT is a valuable tool for diagnosing acute appendicitis.
• Familiarity with the diverse radiological manifestations of appendicitis on helical CT is essential for accurate diagnosis.
• This pictorial review highlights the importance of recognizing the full spectrum of CT findings to prevent diagnostic errors.