CASE 671 Published on 11.11.2001

Gangrenous acute appendicitis


Abdominal imaging

Case Type

Clinical Cases


E. Neri, P.Vagli, C. Spinelli, D. Caramella, F. Pinto


20 years, male

No Area of Interest ; Imaging Technique Ultrasound-Colour Doppler
Clinical History
Acute pain in the right iliac fossa and fever.
Imaging Findings
Patient referred for acute pain in the right iliac fossa and fever. Increase of blood white cells: 11,000. Physical examination revealed tenderness of the abdominal wall. A color doppler US examination was performed.
Although the peak of incidence of acute appendicitis is during the second decade, the rates of perforation and gangrenous evolution is significantly higher in the elderly. Delay in clinical diagnosis is often associated with the onset of major complication. Sonography can show the wall thickening, and Power Doppler technique demonstrates hypervascularisation, and for these reasons represents the modality of choice for an early diagnosis of acute appendicitis; it can also detect the presence of complications avoiding the need for a laparoscopic approach.
Differential Diagnosis List
Gangrenous acute appendicitis
Final Diagnosis
Gangrenous acute appendicitis
Case information
DOI: 10.1594/EURORAD/CASE.671
ISSN: 1563-4086