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[Acute left-side appendicitis: diagnostic contribution of tomodensitometry]
J F Nisolle1, E Bodart, L de Canière
1Service de radiologie, cliniques UCL de Mont-Godinne, Yvoir, Belgique.
Summary
Left-sided appendicitis can occur when a right-sided appendix extends to the left lower quadrant. Computed tomography (CT) scans aid diagnosis when ultrasound is inconclusive for this rare presentation.
Area of Science:
- Medical imaging
- Pediatric surgery
- Gastroenterology
Background:
- Left-sided appendicitis is a rare condition.
- Previous cases have been linked to congenital anomalies like malrotation or situs inversus.
Observation:
- A 9-year-old boy presented with severe left lower quadrant abdominal pain and fever.
- Physical examination revealed tenderness and guarding localized to the left lower quadrant.
- Initial ultrasonography showed a thickened tubular structure, but computed tomography (CT) revealed a perforated, dilated right-sided appendix extending into the left lower quadrant.
Findings:
- The case demonstrates a unique etiology of left-sided appendicitis.
- Computed tomography (CT) successfully identified the anatomical anomaly and perforation.
- Surgical confirmation via median laparotomy validated the diagnosis.
Implications:
- This presentation expands the differential diagnosis for left-sided abdominal pain in children.
- CT imaging is crucial for diagnosing left-sided appendicitis when the appendix originates on the right but extends leftward.
- Early and accurate diagnosis is vital for appropriate surgical management.