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Acute appendicitis confined to the appendiceal tip: evaluation with graded compression sonography
1Department of Radiology, Stanford University School of Medicine, CA 94305.
Summary
Focal appendicitis affecting only the appendix tip can be missed on ultrasounds. Careful examination of the entire appendix is crucial for accurate diagnosis of this specific condition.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Pathology
Background:
- Acute appendicitis is a common surgical emergency.
- Sonographic diagnosis of appendicitis is widely used.
- Focal appendicitis limited to the appendiceal tip is underrepresented in sonographic literature.
Purpose of the Study:
- To highlight sonographic findings of focal appendicitis at the appendiceal tip.
- To emphasize the importance of a thorough appendix examination.
Main Methods:
- Retrospective review of four pathologically confirmed cases of focal appendicitis.
- Analysis of sonographic findings, focusing on appendix base and tip measurements.
Main Results:
- Normal sonographic appearance of the appendix base (4-6 mm diameter) in all cases.
- Focal enlargement of the inflamed appendiceal tip (>7 mm diameter) was observed.
- Sonography can reveal appendicitis confined to the tip.
Conclusions:
- Focal appendicitis at the tip presents unique sonographic findings.
- A comprehensive ultrasound survey of the entire appendix is essential to prevent missed diagnoses.
- Sonography is a valuable tool for identifying tip-confined appendicitis if performed meticulously.