Appendicitis is one
of the commonest causes of emergency department visits. Though it is a common
pathology and has classical clinical features, yet it often presents
atypically. In such cases, the diagnosis is a dilemma especially as there are
many close mimics and these are the cases where imaging helps and ultrasound often
is the first to be undertaken. However ultrasound is largely operator dependent
and frequently provides false negative result. These may be overcome to a large
extent by following a systematic methodology of looking for the pathology.
Based on a review of the articles a basic picture especially for beginners is
[1.] Fox, J. C., Solley, M., Anderson, C. L., et al (2008).
Prospective evaluation of emergency physician performed bedside ultrasound to
detect acute appendicitis. Eur. J. Emerg. Med,;15(2),80-5.
[2.] Han, T. I (2002). Sonographic visualization of the
appendix with a saline enema. J. Ultrasound Med, 21, 511-6.
[3.] Han, T.I (2002). Improved Sonographic Visualization of
the Appendix With a Saline Enema in Children With Suspected Appendicitis. J
Ultrasound Med, 21,511–516.
[4.] Jeffrey, R. B., Jain, K. A., Nghiem, H. V(1994).
Sonographic diagnosis of acute appendicitis: interpretive pitfalls. Am. J.
[5.] Lee, J. H., Jeong, Y. K., Park, K. B., Park, J. K.,
Jeong, A. K., Hwang, J. C (2005). Operator-dependent techniques for Graded
Compression Sonography to Detect the appendix and Diagnose Acute Appendicitis. American
Journal of Roentgenology,184, 91-97.
[6.] Old, J. L., Dusing, R. W., Yap, W., Dirks, J (2005).
Imaging for Suspected Appendicitis. Am Fam Physician, 71(1):71-78.
[7.] Rioux, M (1992). Sonographic detection of the normal
and abnormal appendix. Am. J. Roentgenol, 158, 773-8.
[8.] Sharma, M., Agrawal, A(2008). Pictorial essay: CT scan
of appendicitis and its mimics causing right lower quadrant pain. Indian J
Radiol Imaging, 18(1), 80–89.
[9.] Shin, L. K., Jeffrey, R. B (2010). Sonography and
computed tomography of the mimics of appendicitis. Ultrasound Q,26(4),201-10.
[10.] Tauro, L. F., Premanand, T. S., Aithala, P. S., George
C., Suresh, H. B., Acharya, D., John, P(2009). Ultrasonography Is Still A
Useful Diagnostic Tool In Acute Appendicitis. Journal of Clinical and
Diagnostic Research, 3, 1731-1736.
[11.] Trout, A. T., Sanchez, R., Ladino-Torres, M. F., Pai,
D. R., Strouse, P. J(2012). A critical evaluation of US for the diagnosis of
pediatric acute appendicitis in a real-life setting: how can we improve the
diagnostic value of sonography? Pediatr Radiol, 42(7), 813-23.
[12.] Vriesman, A. V. B., Puylaert, J. B (2006). Mimics of
Appendicitis: Alternative Non surgical Diagnoses with sonography and CT. Am
Jo of Roentgenol, 186,1103-1111.