CT abnormalities in right lower quadrant inflammatory disease: review of findings in 26 adults

Abnormal abdominal computed tomographic (CT) examinations, performed on 26 adults who presented with clinical evidence of right lower quadrant inflammatory disease, were retrospectively studied. Final diagnoses, established surgically in each case, included complicated appendicitis (15 patients), diverticulitis of the ileum or right colon (4), previously undiagnosed Crohn's disease (3), perforated cecal neoplasm (2), right tuboovarian abscess (1), and paracolic abscess of unknown cause (1). The CT features in each diagnostic group are presented in detail. Solid or ring calcification within a pericecal inflammatory mass was specific for appendicitis, occurring in 40% of the 15 patients. Without calcification, the differentiation of complicated appendicitis from Crohn's disease or diverticulitis, based on CT features alone, may be difficult in some cases.