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August 2006

Abnormal appendix.
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Clinical information

Chronic intermittent pain in the right lower abdomen. No signs of peritonitis. The laboratory tests were normal.

Ultrasound Images & Clips

23 year old female, Chronic intermittent pain in the right lower abdomen. No signs of peritonitis. The laboratory tests were normal.

Longitudinal extended field of view image of a more than 1cm. thick non compressible appendix.
Longitudinal extended field of view image of a more than 1cm. thick non compressible appendix.
Longitudinal image of the proximal part of the appendix.
Longitudinal image of the proximal part of the appendix.
Longitudinal image of the tip of the appendix. The appendix is well demarkated and there are no signs of inflammation around the appendix.
Longitudinal image of the tip of the appendix. The appendix is well demarkated and there are no signs of inflammation around the appendix.
Transverse view of the thick non compressible appendix but without inflammatory signs around the appendix.
Transverse view of the thick non compressible appendix but without inflammatory signs around the appendix.
Transverse color doppler image of the appendix with some vascularity of the wall of the appendix.
Transverse color doppler image of the appendix with some vascularity of the wall of the appendix.
A CT scan confirmed the presence of a round thickened appendix without signs of inflamed fat.
A CT scan confirmed the presence of a round thickened appendix without signs of inflamed fat.

Conclusion

Because the laboratory findings were normal and there were no signs of peritonitis the surgeon was reluctant to operate. Because no other explantion for the intermittent abdominal pain could be found, an appendectomy was performed.

The pathologist found a xanthogranolomatous appendicitis without signs of an acute inflammation.

References
Xanthogranulomatous appendicitis--an incidental finding of localized pathology.
Ultrastruct Pathol. 2000 Jan-Feb;24(1):33-9.
Munichor M, Kerner H, Cohen H, Bickel A, Iancu TC

Xanthogranulomatous appendicitis.
J Formos Med Assoc. 2005 Oct;104(10):752-4. Chuang YF, Cheng TI, Soong TC, Tsou MH.

Details

  • Sex: Female
  • Age: 23

Created with

  • Fujifilm Ultrasound System
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photo Taco Geertsma
Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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