Appendix

A free gallery of high-resolution, ultrasound, color doppler and 3D images

Normal anatomical variants of Appendix:

1) Horseshoe shaped appendix

2) Acute appendicitis with appendicolith

3) Perforated appendix or appendiceal perforation

The horseshoe anomaly of the appendix is a rare, normal anatomical variant of the appendix. These ultrasound images show the horsehoe shaped inflammed appendix (forming a sort of inverted U -shape). Note the swollen appendix with echogenic content within it s/o appendicitis (diameter > 6mm.). Ultrasound Images taken using a Philips iU 22 ultrasound machine, courtesy of Dr. Ravi Kadasne, MD, UAE.

Reference: http://www.ncbi.nlm.nih.gov/pubmed/2772830 (abstract- free).

2) Acute appendicitis with appendicolith:

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The above ultrasound images are of a young child (10yrs. old) with pain in the right iliac fossa. These images reveal a typical tubular structure with blind end, showing total diameter more than 6mm.(12 x 15 mm.). These sonographic images reveal hypoechoic content (purulent material) distending the appendix with an echogenic focus floating within it. The appendix was also non-compressible. Color flow imaging shows typical hyervascularity around the organ. These ultrasound images are diagnostic of acute appendicitis with appendicolith.( Images taken with a ATL (Philips HDI 3000 color doppler machine, courtesy of Mr. Shlomo Gobi, Israel).

Reference: 1) http://www.emedicine.com/emerg/topic41.htm (free article and images).

3) Perforated appendix or appendiceal perforation:

Sonography of ruptured appendix:

Sonography of the right iliac fossa reveals 1) distended swollen appendix containing hypoechoic (purulent) fluid with 2) anechoic (fluid) collection anterior to the appendix, with 3)echogenic material (possibly phlegmon) within the fluid. 4) There is evidence of rupture of the proximal part of the appendicular wall. These ultrasound images suggest rupture or perforation of the acutely inflamed appendix.

These sonographic images were taken with a Toshiba Xario ultrasound machine, courtesy of Dr. Gunjan Puri, Surat, India.

Reference: 1) http://www.medicinenet.com/appendicitis/article.htm (free article and pictures)

2) http://www.aafp.org/afp/20050101/71.html (free article and images).. rated excellent

4) Acute appendicitis- case-2:

Long section ultrasound/ Power Doppler images of appendix:

Increased vascularity of the appendix- long section: Oblique section Power Doppler image:

Cross section (transverse section)- Markedly vascular appendix:

This male child has a markedly vascular and swollen appendix at 5 to 7 mm. width. Using graded compression it was possible to visualize the acutely inflamed appendix in its entirety. These ultrasound and Power Doppler images show a typical case of acute appendicitis. The Power Doppler ultrasound image at bottom shows a literal ring of fire within the cross section of the inflamed appenidx. Such a case may or may not respond to conservative medical treatment and surgery may be the final option. Fortunately for the patient there is no evidence of impending rupture of the appendix at the present stage. There is no evidence of collection of fluid (phlegmon) around the appendix.

Here is the ultrasound and Power Doppler video clip of this case:

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This page was last edited on: Tuesday October 11, 2011 01:20 PM

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