Appendicitis - CT findings. Familiarise yourself with the appearances.

Appendicitis - CT findings. This video presents a typical case of appendicitis. You can familiarise yourself with the appearances.

[@chrisgustafson9342]

I had appendicitis that my gp kept saying was "female issues" until one I was taken to ER walking like a duck. It ruptured, formed a two-quart abcess on my right fallopian tube which then ruptured two weeks after my gp appointment. Had to have everything taken out and washed before it was put back in. Then my big ab incision was left open and a 60 foot rope of iodine soaked gauze replaced every morning with very long forceps. 43 pints of iv antibiotics and half a month later I was sent home with a Montgomery Wrap which is two notebook size adhesive bandaids laced shut. Then every week for six more week, my internal med doc would unlace me then yank the incision open side to side so I healed from inside outward. After that he had to burn off Proud Flesh. Lastly, two years later, I had to have a permanent internal stitch the thickness of ocean fishing line removed because the snipped ends worked thru my skin to the surface

[@RadiologyInterestingCase-pk3uk]

Sorry to read this unfortunate complication. Basicaly it is quite often either because of the physician underestimation or the patient's rapid progress of the disease or for other reasons. The good think is that you won, despite the long cure. Always a second opinion, if the symptoms persist, save lives. All the best! Athan.

[@davidmitchell3881]

It might be worth adding an ultrasound image. As long as the appendix is not retrocaecal its easy to see the inflammed appendix. No radation. Lower cost.
There some things better seen on CT. About 1% or less of appendices have a tumour either in the appendix or in the caecum.
While acute appendix can be a very simple diagnosis it can be very difficult also. I rememer one presenting with right testicular pain. Nerve irritation. Another with epigastic pain. Another had ruptured and presented with a swollen vulva. Free pus in the abdomen.
Never forget the pregnancy test in women of reproductive age. Ectopics occur.
I have a patient with a left sided appendix. Non rotation of the colon. Incidental finding on CT. Sorry i dont have yhe images. Otherwise pretty normal. Has Elhers Danlos syndrome but i dont think there is a connection.
Finally the chronic or recurrent appendix. This is real. About 25% of appendices are due to infection by Yersinia. Other bugs are involved also but this seems to be the most common. About 70% of appendices can be treated witj antibiotics but there is a recurrence rate and some end up in surgery. I had a lovely young boy in a while ago. Previous diagnosis of appendicitis. Treated with antibiotics. Did well. Woke up one morning and told his mother the pain was back exactly like the first time and he needed to see the doctor. Mum didnt believe him so he went to school. School rang mum and he ended up in the doctors. Ultrasound confirmed early recurrent appendix. He is fine now.
As they taught me in med school - listen to the patient. They are telling you the diagnosis 😂
Expert patient - all of 7 years old