EURORAD ESR

Case 14017

Situs Inversus Appendicitis with NO clear LLQ pain: not so surprising as you might think

Author(s)
Teiga, Eduardo; Bazan, Fernando; Consola, Beatriz; Arenas, Natalia

Hospital Universitario del Mar; Passeig Maritim 08005 Barcelona, Spain; Email:eduardo_teiga@hotmail.com
 
Patient
male, 22 year(s)
 
 
  • Figure 1
    Chest x-ray

    Dextrocardia

     
    Area of Interest: Thorax; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 2
    Abdominal x-ray

    Liver silhouette depicted at the left side

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 3
    US
     

    US revealed an aperistaltic, noncompressible, dilated appendix with periappendiceal fluid and echogenic prominent pericaecal fat. Target appearance is clearly depicted.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    US revealed an aperistaltic, noncompressible, dilated appendix with periappendiceal fluid and echogenic prominent pericaecal fat. Target appearance is clearly depicted.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 4
    CT
     

    CT confimed a total transposition of abdominal and thoracic viscera and better depicts the situs inversus.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Congenital;

    CT depicts an appendix with distended lumen and thickened and enhancing walls. Stranding of the adjacent fat is also present.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    CT depicts an appendix with distended lumen and thickened and enhancing walls. Stranding of the adjacent fat is also present.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    CT depicts an appendix with distended lumen and thickened and enhancing walls. Stranding of the adjacent fat is also present.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
Dextrocardia
 
Liver silhouette depicted at the left side
 
US revealed an aperistaltic, noncompressible, dilated appendix with periappendiceal fluid and echogenic prominent pericaecal fat. Target appearance is clearly depicted.
 
US revealed an aperistaltic, noncompressible, dilated appendix with periappendiceal fluid and echogenic prominent pericaecal fat. Target appearance is clearly depicted.
 
CT confimed a total transposition of abdominal and thoracic viscera and better depicts the situs inversus.
 
CT depicts an appendix with distended lumen and thickened and enhancing walls. Stranding of the adjacent fat is also present.
 
CT depicts an appendix with distended lumen and thickened and enhancing walls. Stranding of the adjacent fat is also present.
 
CT depicts an appendix with distended lumen and thickened and enhancing walls. Stranding of the adjacent fat is also present.
 
 
 
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