الفهرس 
Anatomy, ultrasound and CT anatomy of the appendixOnly 14 pages are availabe for public view
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Abstract
Appendicitis is the most common cause of acute abdominal pain that requires surgical intervention.
Patients may present with a wide variety of clinical manifestations, and the diagnosis may elude even the most experienced clinicians. The clinical diagnosis is based primarily on the patient history, physical examinations and white blood cell count. While the clinical diagnosis may be straight forward in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Ultrasonography and MDCT are used to improve the diagnostic performance and establish an alternative diagnosis of diseases that may mimic acute appendicitis
Sonographic visualization of a non compressible, aperistaltic appendix measuring greater than 6 mm in diameter is considered indicative of acute appendicitis.
MSCT signs of appendicitis include an appendix measuring greater than 6 mm in diameter, failure of the appendix to fill with oral contrast medium or air up to its tip, and enhancement of its wall with intravenous contrast medium.
Surrounding inflammatory changes, presence of ceacal thickening ,abscess ,lymphadenopathy are helpful signs in diagnosing acute appendicitis.
Ultrasonography and MDCT also are useful in diagnosing complications of acute appendicitis eg. appendiceal perforation, phlegmon or an abscess formation, hepatic abscess.
Ultrasonography and MDCT are powerful in diagnosing acute appendicitis, but also in evaluating a number of conditions that mimic appendicitis clinically, eg. cecal diverticulitis, torsion of Meckel’s diverticulum, infectious colitis, crohn’s disease ,acute cholecystitis, gynecologic disorders as ovarian cysts ,ovarian torsion.
Conclusion :
Sonography should ideally be used in the initial evaluation of diagnosis of acute appendicitis in the pediatric patient, pregnant females and the thin patient but its disadvantage that it is operator dependence and require good preparation of the patient where as CT should be used in obese patient and better in diagnosis of complications of acute appendicitis but its disadvantage that it is expensive and high dose radiation .
Ultrasonography examination should be the first imaging examination for the diagnosis of acute appendicitis in adult patients, whereas CT should follow the sonography examination in selected cases.