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Distal appendicitis: CT appearance and diagnosis

P M Rao1, J T Rhea, R A Novelline

  • 1Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.

Radiology
|September 1, 1997
PubMed
Summary

Computed tomographic (CT) scans accurately diagnose distal appendicitis. Even with a normal-appearing proximal appendix, CT findings can reveal inflammation in the distal appendix, aiding diagnosis.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Surgical Pathology

Background:

  • Distal appendicitis, inflammation in the terminal part of the appendix, presents diagnostic challenges.
  • Computed tomography (CT) is a key imaging modality for diagnosing appendicitis.

Purpose of the Study:

  • To characterize the CT appearance of distal appendicitis.
  • To assess the diagnostic accuracy of CT for distal appendicitis.

Main Methods:

  • Retrospective review of CT scans and medical records from 180 patients with confirmed appendicitis.
  • Analysis focused on 14 patients with distal appendicitis and a normal proximal appendix.
  • Evaluation of CT findings, including appendiceal diameter, surrounding inflammation, and transition points.

Main Results:

  • Distal appendicitis cases showed inflamed appendices averaging 13.2 mm in diameter.
  • Associated findings included periappendiceal fat stranding, adenopathy, appendoliths, and fluid.
  • CT scans correctly identified appendicitis in all 14 distal appendicitis cases, with 86% specifically indicating distal involvement.

Conclusions:

  • CT findings are valuable for accurately diagnosing distal appendicitis.
  • A normal-appearing proximal appendix on CT does not exclude distal appendicitis.

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