Coiled-spring sign of appendiceal intussusception.

Area of Science:

• Gastroenterology
• Radiology
• Abdominal Imaging

Background:

• Appendiceal intussusception is historically considered rare and challenging to diagnose radiographically.
• Previous diagnostic challenges may have underestimated its true incidence.

Purpose of the Study:

• To identify and characterize the radiographic findings of appendiceal intussusception on double-contrast barium enema (DCE) examinations.
• To evaluate the clinical presentation and transient nature of appendiceal intussusception.

Main Methods:

• Retrospective review of 11 cases with apparent or proven appendiceal intussusception on DCE examinations.
• Analysis of radiographic findings, including the characteristic coiled-spring appearance.
• Correlation with surgical findings and clinical outcomes where available.

Main Results:

• A characteristic coiled-spring appearance in the cecum, with nonfilling of the appendix, was observed in 11 cases.
• Two surgically confirmed cases were linked to appendiceal mucocele and endometriosis.
• Four cases demonstrated transient intussusception, with the defect resolving on follow-up imaging.
• Most patients were asymptomatic, with only one reporting appendiceal-related symptoms.

Conclusions:

• Appendiceal intussusception can often be a transient, asymptomatic condition.
• The coiled-spring appearance on DCE is a reliable diagnostic sign.
• Routine DCE examinations can effectively diagnose appendiceal intussusception.