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CT Abd Appendicitis

Technique: Helical CT scan examination of the abdomen and pelvis was performed following the IV administration of 100 ml of non-ionic contrast Isovue-300. Oral contrast was given prior to the start of the study. Standard 5 mm axial images were obtained with coronal and sagittal reformations. Renal delay images were also obtained.

  1. Proximal appendix is dilated around the appendicolith measuring approximately 1 cm in diameter. There is cecum wall thickening with extension of edema to terminal ileum. There is adjacent periappendiceal fat infiltration with mild amount of intraperitoneal free fluid in the dependent portions of the pelvis consistent with infectious process or may be also normal variant. No abscess formation is noted. No evidence of small bowel obstruction or perforation.

  2. Oral contrast has progressed to the descending colon. Contrast opacifies only the proximal portion of the appendiceal lumen. The appendix is retrocecal in location and is slightly thickened, with a maximal diameter of just under 9 mm. There is subtle infiltration of the periappendiceal fat. There are are no fluid collections and there is no pneumoperitoneum.

  3. Contrast is seen within the gastrointestinal tract to the level of the descending colon. There is a fluid-filled blind-ending tubular structure which arises from the cecum and extends posterior, medial and inferiorly toward the sacrum. This measures approximately 10 mm in greatest dimension. There is no significant periappendiceal fat stranding appreciated, however there is a paucity of mesenteric fat in this patient.

Conclusion: Acute noncomplicated appendicitis.