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August 2015

13 year old boy with signs of an appendicitis
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Clinical information

Admitted to the hospital with clinical signs of an appendicitis.

Ultrasound Images & Clips

13 year old boy with signs of an appendicitis

There is an oval structure with signs of inflammation
There is an oval structure with signs of inflammation
There are a few airbubbles
There are a few airbubbles
The wall of the lesion is vascularized
The wall of the lesion is vascularized
This is the longitudinal image of the same structure
This is the longitudinal image of the same structure
Another longitudinal image Is this the appendix?
Another longitudinal image Is this the appendix?
The fat surrounding the structure is inflamed
The fat surrounding the structure is inflamed
The terminal ileum is normal
The terminal ileum is normal
This is the transverse image of the appendix which is normal
This is the transverse image of the appendix which is normal
This the longitudinal image of the appendix which again is normal
This the longitudinal image of the appendix which again is normal
This the tip of the long appendix. An appendicitis was excluded.
This the tip of the long appendix. An appendicitis was excluded.
This another case of a middle aged man with the same symptoms. The cecal was is thickened
This another case of a middle aged man with the same symptoms. The cecal was is thickened
The problem seems to lie next to the cecum
The problem seems to lie next to the cecum
The illeal wall is slightly thickened
The illeal wall is slightly thickened
There is increase vascularity consisten with inflammation
There is increase vascularity consisten with inflammation
This is a transverse view of what looks like an inflamed appendix. No normal appendix could be found. A CT scan was performed
This is a transverse view of what looks like an inflamed appendix. No normal appendix could be found. A CT scan was performed
CT
CT
CT

Conclusion

In the first case, because there were signs of an inflammation in the right lower abdomen the surgeon decided to operate although the radiologist advised to do an MRI or a CT scan because he thought it was a cecal or right sided diverticulitis and not an appendicitis At operation it proved not to be an appendicitis but a cecal diverticulitis.

The second patient did have an appendicitis with a cecitis The appendix was short and had perforated.
Not everery inflammation in the right lower abdomen is an appendicitis. Beware of other pathology. If the surgeon had believed the radiologist or had requested an adjuvant CT scan or MRI the first patient would possibly not have been operated

Details

  • Sex: Male
  • Age: 13

Created with

  • Fujifilm Ultrasound System
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photo Taco Geertsma
Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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