36 Appendicitis Fig. 36.1A This patient has a calcified density projected over the right ilium. This is an appendicolith in appendicitis. Background Appendicitis is one of the commonest surgical emergencies and can be a difficult diagnosis to make, as it can present in a variety of ways in a wide range of ages. No single clinical finding, simple blood test or imaging modality can be used to reliably make the diagnosis, although US and CT are the best modalities where complex imaging is used. The AXR is not routinely indicated if appendicitis is suspected but it is useful to be aware of the AXR features if they are present in the patient who has undergone AXR for abdominal pain. Clinical features Appendicitis can present in several ways, classically with colicky central abdominal pain which migrates to the right iliac fossa and becomes worse on movement. Anorexia, fever and dysuria can be useful additional symptoms to elicit. Signs include tenderness and rebound in the right iliac fossa (RIF), pain in the RIF on pressing the LIF (Rovsing sign), and tenderness on rectal examination (in a pelvic appendix). Differential diagnosis This is wide, particularly in young females, and includes: • mesenteric adenitis and Meckel’s diverticulum in children Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Small bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Appendicitis Full access? Get Clinical Tree
36 Appendicitis Fig. 36.1A This patient has a calcified density projected over the right ilium. This is an appendicolith in appendicitis. Background Appendicitis is one of the commonest surgical emergencies and can be a difficult diagnosis to make, as it can present in a variety of ways in a wide range of ages. No single clinical finding, simple blood test or imaging modality can be used to reliably make the diagnosis, although US and CT are the best modalities where complex imaging is used. The AXR is not routinely indicated if appendicitis is suspected but it is useful to be aware of the AXR features if they are present in the patient who has undergone AXR for abdominal pain. Clinical features Appendicitis can present in several ways, classically with colicky central abdominal pain which migrates to the right iliac fossa and becomes worse on movement. Anorexia, fever and dysuria can be useful additional symptoms to elicit. Signs include tenderness and rebound in the right iliac fossa (RIF), pain in the RIF on pressing the LIF (Rovsing sign), and tenderness on rectal examination (in a pelvic appendix). Differential diagnosis This is wide, particularly in young females, and includes: • mesenteric adenitis and Meckel’s diverticulum in children Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Small bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Appendicitis Full access? Get Clinical Tree
