Figure 1
Acute pain in the right iliac fossa and fever.
Gangrenous acute appendicitis
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.
References
[1] Carr NJ. et al. The pathology of acute appendicitis. Ann Diagn Pathol 2000; 4 (1): 46-58. (PMID: 10684382)
[2] Elangovan S. et al. Incidence of acute appendicitis confirmed by histopathologic diagnosis. Kans Med. 1997; 98 (2): 10-3. (PMID: 9604611)
[3] Lim HK. Ey al. Appendicitis: usefullness of color Doppler US. Radiology 1996; 201 (1): 221-5. (PMID: 8816547)
[4] Skaane P.et al. Ultrasonography in patient with suspect acute appendicitis. prospective study. Br J Radiol 1990; 63 (754): 787-93. (PMID: 2242476)
Case information
| URL: | https://www.eurorad.org/case/671 |
| DOI: | 10.1594/EURORAD/CASE.671 |
| ISSN: | 1563-4086 |
