Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Birnbaum, B. A.
Right arrow Articles by Wilson, S. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Birnbaum, B. A.
Right arrow Articles by Wilson, S. R.
(Radiology. 2000;215:337-348.)
© RSNA, 2000

State of the Art

Appendicitis at the Millennium1

Bernard A. Birnbaum, MD and Stephanie R. Wilson, MD

1 From the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (B.A.B.); and the Department of Medical Imaging, the Toronto Hospital, General Division, Ontario, Canada (S.R.W.). Received March 10, 1999; revision requested May 3; revision received June 29; accepted July 22. Address correspondence to B.A.B. (e-mail: birnbaum@oasis.rad.upenn.edu).

Abstract

Acute appendicitis is a common clinical problem. Accurate and prompt diagnosis is essential to minimize morbidity. While the clinical diagnosis may be straightforward in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Helical computed tomography (CT) and graded compression color Doppler ultrasonography (US) are highly accurate means of establishing the diagnosis. These imaging modalities have now assumed critical roles in the treatment of patients suspected to have appendicitis. The purpose of this article is threefold: to provide an update on new information regarding the pathophysiology, clinical diagnosis, and laparoscopic treatment of acute appendicitis; to describe the state-of-the art use of CT and US in diagnosing this disease entity; and to address the role of medical imaging in this patient population.

Index terms: Appendicitis, 751.291 • Appendix, CT, 751.12112, 751.12115 • Appendix, US, 751.12983 • State of the Art




This article has been cited by other articles:


Home page
 Am. J. Roentgenol.Home page
H. Seo, K. H. Lee, H. J. Kim, K. Kim, S.-B. Kang, S. Y. Kim, and Y. H. Kim
Diagnosis of Acute Appendicitis With Sliding Slab Ray-Sum Interpretation of Low-Dose Unenhanced CT and Standard-Dose IV Contrast-Enhanced CT Scans
Am. J. Roentgenol., July 1, 2009; 193(1): 96 - 105.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
I. Pedrosa, M. Lafornara, P. V. Pandharipande, J. D. Goldsmith, and N. M. Rofsky
Pregnant Patients Suspected of Having Acute Appendicitis: Effect of MR Imaging on Negative Laparotomy Rate and Appendiceal Perforation Rate
Radiology, March 1, 2009; 250(3): 749 - 757.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
A. van Randen, S. Bipat, A. H. Zwinderman, D. T. Ubbink, J. Stoker, and M. A. Boermeester
Acute Appendicitis: Meta-Analysis of Diagnostic Performance of CT and Graded Compression US Related to Prevalence of Disease
Radiology, October 1, 2008; 249(1): 97 - 106.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
K. S. Lee, N. M. Rofsky, and I. Pedrosa
Localization of the Appendix at MR Imaging during Pregnancy: Utility of the Cecal Tilt Angle
Radiology, October 1, 2008; 249(1): 134 - 141.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
D. Gaitini, N. Beck-Razi, D. Mor-Yosef, D. Fischer, O. B. Itzhak, M. M. Krausz, and A. Engel
Diagnosing Acute Appendicitis in Adults: Accuracy of Color Doppler Sonography and MDCT Compared with Surgery and Clinical Follow-Up
Am. J. Roentgenol., May 1, 2008; 190(5): 1300 - 1306.
[Abstract] [Full Text] [PDF]

Home page
 RadioGraphicsHome page
H. C. Kim, D. M. Yang, W. Jin, and S. J. Park
Added Diagnostic Value of Multiplanar Reformation of Multidetector CT Data in Patients with Suspected Appendicitis
RadioGraphics, March 1, 2008; 28(2): 393 - 405.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
M. Tsuboi, K. Takase, I. Kaneda, T. Ishibashi, T. Yamada, M. Kitami, S. Higano, and S. Takahashi
Perforated and Nonperforated Appendicitis: Defect in Enhancing Appendiceal Wall Depiction with Multi Detector Row CT
Radiology, January 1, 2008; 246(1): 142 - 147.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Radiol.Home page
N H Park, C S Park, E J Lee, M S Kim, J A Ryu, J M Bae, and J S Song
Ultrasonographic findings identifying the faecal-impacted appendix: differential findings with acute appendicitis
Br. J. Radiol., November 1, 2007; 80(959): 872 - 877.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
A. B. Kharbanda, G. A. Taylor, and R. G. Bachur
Suspected Appendicitis in Children: Rectal and Intravenous Contrast-enhanced versus Intravenous Contrast-enhanced CT
Radiology, May 1, 2007; 243(2): 520 - 526.
[Abstract] [Full Text] [PDF]

Home page
 RadioGraphicsHome page
I. Pedrosa, E. A. Zeikus, D. Levine, and N. M. Rofsky
MR Imaging of Acute Right Lower Quadrant Pain in Pregnant and Nonpregnant Patients
RadioGraphics, May 1, 2007; 27(3): 721 - 743.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
K. Yabunaka, T. Katsuda, S. Sanada, and T. Fukutomi
Sonographic Appearance of the Normal Appendix in Adults
J. Ultrasound Med., January 1, 2007; 26(1): 37 - 43.
[Abstract] [Full Text] [PDF]

Home page
 ImagingHome page
E M Anderson and H K Bungay
Imaging investigation of acute right iliac fossa pain
Imaging, December 1, 2006; 18(4): 257 - 267.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
A. S. Doria, R. Moineddin, C. J. Kellenberger, M. Epelman, J. Beyene, S. Schuh, P. S. Babyn, and P. T. Dick
US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis
Radiology, October 1, 2006; 241(1): 83 - 94.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
J. E. Jacobs
CT and Sonography for Suspected Acute Appendicitis: A Commentary.
Am. J. Roentgenol., April 1, 2006; 186(4): 1094 - 1096.
[Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
A. C. van Breda Vriesman and J. B. C. M. Puylaert
Mimics of Appendicitis: Alternative Nonsurgical Diagnoses with Sonography and CT.
Am. J. Roentgenol., April 1, 2006; 186(4): 1103 - 1112.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
C. Keyzer, M. Zalcman, V. De Maertelaer, E. Coppens, M.-A. Bali, P. A. Gevenois, and D. Van Gansbeke
Comparison of US and Unenhanced Multi-Detector Row CT in Patients Suspected of having Acute Appendicitis
Radiology, August 1, 2005; 236(2): 527 - 534.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
I. Chan, S. G. Bicknell, and M. Graham
Utility and Diagnostic Accuracy of Sonography in Detecting Appendicitis in a Community Hospital
Am. J. Roentgenol., June 1, 2005; 184(6): 1809 - 1812.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
R. Menten, P. Lebecque, C. Saint-Martin, and P. Clapuyt
Outer Diameter of the Vermiform Appendix: Not a Valid Sonographic Criterion for Acute Appendicitis in Patients with Cystic Fibrosis
Am. J. Roentgenol., June 1, 2005; 184(6): 1901 - 1903.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
C. D. Levine, O. Aizenstein, O. Lehavi, and A. Blachar
Why We Miss the Diagnosis of Appendicitis on Abdominal CT: Evaluation of Imaging Features of Appendicitis Incorrectly Diagnosed on CT
Am. J. Roentgenol., March 1, 2005; 184(3): 855 - 859.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
F. J. Moulding, S. C. Roach, and A. E. Hanbidge
Thrombosed Pelvic Collateral Veins Resulting from Anomalous Inferior Vena Cava: A Mimicker of Acute Appendicitis
Am. J. Roentgenol., February 1, 2005; 184(2): 703 - 704.
[Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
J. H. Lee, Y. K. Jeong, K. B. Park, J. K. Park, A. K. Jeong, and J. C. Hwang
Operator-Dependent Techniques for Graded Compression Sonography to Detect the Appendix and Diagnose Acute Appendicitis
Am. J. Roentgenol., January 1, 2005; 184(1): 91 - 97.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
T. Terasawa, C. C. Blackmore, S. Bent, and R. J. Kohlwes
Systematic Review: Computed Tomography and Ultrasonography To Detect Acute Appendicitis in Adults and Adolescents
Ann Intern Med, October 5, 2004; 141(7): 537 - 546.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
C. Keyzer, D. Tack, V. de Maertelaer, P. Bohy, P. A. Gevenois, and D. Van Gansbeke
Acute Appendicitis: Comparison of Low-Dose and Standard-Dose Unenhanced Multi-Detector Row CT
Radiology, July 1, 2004; 232(1): 164 - 172.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
S. Kaiser, T. Finnbogason, H. K. Jorulf, E. Soderman, and B. Frenckner
Suspected Appendicitis in Children: Diagnosis with Contrast-enhanced versus Nonenhanced Helical CT
Radiology, May 1, 2004; 231(2): 427 - 433.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
N. Kessler, C. Cyteval, B. Gallix, A. Lesnik, P.-M. Blayac, J. Pujol, J.-M. Bruel, and P. Taourel
Appendicitis: Evaluation of Sensitivity, Specificity, and Predictive Values of US, Doppler US, and Laboratory Findings
Radiology, February 1, 2004; 230(2): 472 - 478.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
P. Poortman, P. N. M. Lohle, C. M. C. Schoemaker, H. J. M. Oostvogel, H. J. L. J. M. Teepen, K. A. H. Zwinderman, and J. F. Hamming
Comparison of CT and Sonography in the Diagnosis of Acute Appendicitis: A Blinded Prospective Study
Am. J. Roentgenol., November 1, 2003; 181(5): 1355 - 1359.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
J. T. Rexroad
The CT Arrowhead Sign
Radiology, April 1, 2003; 227(1): 44 - 45.
[Full Text] [PDF]

Home page
 NEJMHome page
E. K. Paulson, M. F. Kalady, and T. N. Pappas
Suspected Appendicitis
N. Engl. J. Med., January 16, 2003; 348(3): 236 - 242.
[Full Text] [PDF]

Home page
 RadiologyHome page
S. Puig, M. Hormann, W. Rebhandl, R. Felder-Puig, M. Prokop, and K. Paya
US as a Primary Diagnostic Tool in Relation to Negative Appendectomy: Six Years Experience
Radiology, January 1, 2003; 226(1): 101 - 104.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
S. E. Bendeck, M. Nino-Murcia, G. J. Berry, and R. B. Jeffrey Jr
Imaging for Suspected Appendicitis: Negative Appendectomy and Perforation Rates
Radiology, October 1, 2002; 225(1): 131 - 136.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
P. J. Pickhardt, A. D. Levy, C. A. Rohrmann Jr, and A. I. Kende
Primary Neoplasms of the Appendix Manifesting as Acute Appendicitis: CT Findings with Pathologic Comparison
Radiology, September 1, 2002; 224(3): 775 - 781.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
M. J. Callahan, D. P. Rodriguez, and G. A. Taylor
CT of Appendicitis in Children
Radiology, August 1, 2002; 224(2): 325 - 332.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
S. Kaiser, B. Frenckner, and H. K. Jorulf
Suspected Appendicitis in Children: US and CT— A Prospective Randomized Study
Radiology, June 1, 2002; 223(3): 633 - 638.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
P. J. Pickhardt, A. D. Levy, C. A. Rohrmann Jr., S. L. Abbondanzo, and A. I. Kende
Non-Hodgkin's Lymphoma of the Appendix: Clinical and CT Findings with Pathologic Correlation
Am. J. Roentgenol., May 1, 2002; 178(5): 1123 - 1127.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
D. R. Flum, A. Morris, T. Koepsell, and E. P. Dellinger
Has Misdiagnosis of Appendicitis Decreased Over Time?: A Population-Based Analysis
JAMA, October 10, 2001; 286(14): 1748 - 1753.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
J. E. Jacobs, B. A. Birnbaum, M. Macari, A. J. Megibow, G. Israel, D. D. Maki, A. M. Aguiar, and C. P. Langlotz
Acute Appendicitis: Comparison of Helical CT Diagnosis—Focused Technique with Oral Contrast Material versus Nonfocused Technique with Oral and Intravenous Contrast Material
Radiology, September 1, 2001; 220(3): 683 - 690.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
J. M. Grönroos and P. Grönroos
Diagnosis of Acute Appendicitis
Radiology, April 1, 2001; 219(1): 297 - 298.
[Full Text]