The appendix is a tubular, blind ending structure at the base of the cecum averaging 3 inches in length, with no known physiology. Acute appendicitis is inflammation of the appendix and is seen to have the greatest occurrence between the ages of 10-19 years.1 Patients with acute appendicitis commonly show a positive McBurney’s sign.1,2,3 Luminal obstruction and inflammation are the most common causes resulting from hyperplasia, parasites and foreign bodies in the appendix.2 Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound (US) are all imaging modalities with special qualities specific in finding causes for abdominal pain including appendicitis. Ultrasound, being operator dependent, has specific techniques used in locating the appendix and visualizing abnormalities that correlate with appendicitis. Differentials for acute appendicitis consist of gastrointestinal structural and pelvic pathologies.2,4 Appendectomy (surgical removal of the appendix) is used as treatment along with rare incidences of nonsurgical, antibiotic treatments.5
Keywords: appendicitis, McBurney’s sign, appendectomy
Clinical Presentation of Acute Appendicitis:
Emphasis on Sonographic Exam
Introduction
Acute appendicitis
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Other symptoms may include irritability, lethargy, abdominal pain, and diarrhea.2 The most significant clinical finding is RLQ pain on palpation. A quick release method of applying pressure with fingertips directly over area of the appendix and quickly releasing is employed looking for rebound tenderness—this is known as a positive McBurney’s sign. Elevated WBC count of over 10,000/mm3 is associated with 90% of AA cases; however, 60% of patients with a normal appendix also have an elevated WBC