How effective is CT scanning when evaluating atypical presentations of appendicitis?

Updated: Jul 23, 2018
  • Author: Sandy Craig, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Computed tomography (CT) scanning with oral contrast medium or rectal Gastrografin enema has become the most important imaging study in the evaluation of patients with atypical presentations of appendicitis. Intravenous contrast is usually not necessary.

Studies have found a decrease in negative laparotomy rate and appendiceal perforation rate when pelvic CT imaging was used in selected patients with suspected appendicitis. [37, 38, 39, 40] An enlarged appendix is shown in the CT below.

CT scan reveals an enlarged appendix with thickene CT scan reveals an enlarged appendix with thickened walls, which do not fill with colonic contrast agent, lying adjacent to the right psoas muscle.

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