Acute appendicitis - pediatric

Case contributed by Dr Alborz Jahangiri

Presentation

Right sided back pain for 4 days.

Patient Data

Age: 2 years
Gender: Male
Ultrasound

The right iliac fossa was examined by ultrasound using the graded compression technique.

A thickened, incompressible appendix (>6 mm) is seen with distinct wall layers as a blind-ending tube arising from the medial aspect of the cecum.

There is also surrounding abnormally echogenic mesenteric fat.

Ileocecal lymphadenopathy is also noted.

Case Discussion

Ultrasound is the investigation of choice in young patients being investigated for acute appendicitis.

Graded compression ultrasound is the technique used.

Findings to support the diagnosis are: 

  • aperistaltic, incompressible, dilated appendix (>6 mm outer diameter)
  • target appearance
  • periappendiceal fluid collection
  • periappendiceal hyperechoic structure
  • echogenic prominent pericaecal fat
  • appendicolith
  • distinct appendiceal wall layers
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Case information

rID: 48029
Published: 15th Sep 2016
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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