June 15, 2011 by dailybolusoflr
Appendicitis is most commonly diagnosed on CT of the abdomen and pelvis.
A non-contrast CT is about 90% and with contrast (oral or IV) the sensitivity increases to around 97-98%. CT also has a high specificity, around 94-95%.
There are many findings on CT which are suspicious for appendicitis and they include the following:
· A fecalith
· Stranding in the surrounding fat or periappendiceal fluid
· Surrounding abscess or phlegmon
The classic finding for appendicitis seen on CT (A dilated thickened tubular appearing appendix, greater than 6mm, with inflammatory stranding) can be seen here on EMPACS:
(type in search term of “appendicitis”)
Additional images can be viewed here
Linda Regan, MD FACEP
Program Director, Emergency Medicine Residency
Johns Hopkins Medical Institutions