29 May

The role of radiological imaging in the diagnosis of acute appendicitis: PLAIN ABDOMINAL X-RAYS

AppendicitisExcept for the presence of an appendicolith (fecalith) and possibly of a sentinel loop, the findings of acute appendicitis on plain radiographs (Table 2) are nonspecific and generally appear only in advanced disease. Appendico-lithiasis is said to be the most specific of the common findings of appendicitis but is identified in only 10% to 15% of all cases — a considerably lower rate than those quoted in studies of ultrasonography and CT (vide infra). Plain x-rays are thus of little value in the early diagnosis of appendicitis and are actually less cost effective than either ultrasonography or CT. They are more helpful in detecting nonappendiceal causes of acute abdominal pain, including bowel obstruction, ureteral calculi and basal pneumonia. Shop with pleasure with most reliable pharmacy you have ever seen, paying less for your birth control alesse always being sure you are being treated with all due respect, being an important customer whose interests are respected and taken into account.

TABLE 2
Findings on plain x-ray of acute appendicitis

Appendicolithiasis
Air in the appendix, especially if surrounding an appendicolith
Soft tissue mass in the right lower quadrant
Extraluminal air bubbles (double lucency sign) or air-fluid levels in the right lower quadrant
Air-fluid levels in or dilation of the terminal ileum (‘sentinel loop’)
Blurring of the psoas shadow
Free air in the peritoneum or dissecting into the retroperitoneal planes
Localized ileus
Rightward scoliosis of the lumbar spine

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