Abstract
OBJECTIVE: To describe the clinical presentation and computed tomographic (CT) features of ascending retrocecal appendicitis. METHODS: During the past 8 years, 1670 patients with surgically proven appendicitis were identified by a retrospective investigation. Thirty-three patients who underwent contrast-enhanced abdominal CT before surgery and had ascending retrocecal appendicitis at surgery were included in the patient cohort. The clinical and CT findings of these 33 patients were analyzed. RESULTS: Patients presented with right lower abdominal pain (49%, 16/33), right flank pain (24%, 8/33), right upper abdominal pain (18%, 6/33), and periumbilical pain (15%, 5/33). Inflamed ascending retrocecal appendices were visualized completely in 70% (23/33), partially in 21% (7 of 33), and not detected in the remaining 9% (3/33). Periappendiceal inflammatory changes were most commonly observed in the retrocolic space in 88% (29/33), followed by paracolic gutter (30%, 10/33), pararenal space (27%, 9/33), mesentery (24%, 8/33), perirenal space (18%, 6/33), and subhepatic space (3%, 1/33). Inflammatory thickening of Gerota fascia (70%, 23/33) and the lateroconal fascia (64%, 21/33) was observed as well. Perforation of the appendix with the formation of an abscess was present in 49% (16/33). The abscesses were most commonly located in the retrocolic space (88%, 14/16). Diffuse wall thickenings of the cecum (67%, 22/33) and the ascending colon (64%, 21/33) were often observed also. Appendicoliths were found in 33% (11/33). CONCLUSIONS: More than half of patients with ascending retrocecal appendicitis presented with atypical clinical presentation. At CT, ascending retrocecal appendicitis was associated with a high incidence of retroperitoneal inflammatory changes and appendiceal perforation.
| Original language | English |
|---|---|
| Pages (from-to) | 772-776 |
| Number of pages | 5 |
| Journal | Journal of Computer Assisted Tomography |
| Volume | 30 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2006 Sep 1 |
| Externally published | Yes |
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Keywords
- Appendicitis
- Appendix
- Computed tomography
- Diagnosis
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Ascending retrocecal appendicitis : Clinical and computed tomographic findings. / Kim, Sooah; Lim, Hyo K.; Lee, Ji Yeon; Lee, Jongmee; Kim, Min Ju; Lee, Soon Jin.
In: Journal of Computer Assisted Tomography, Vol. 30, No. 5, 01.09.2006, p. 772-776.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ascending retrocecal appendicitis
T2 - Clinical and computed tomographic findings
AU - Kim, Sooah
AU - Lim, Hyo K.
AU - Lee, Ji Yeon
AU - Lee, Jongmee
AU - Kim, Min Ju
AU - Lee, Soon Jin
PY - 2006/9/1
Y1 - 2006/9/1
N2 - OBJECTIVE: To describe the clinical presentation and computed tomographic (CT) features of ascending retrocecal appendicitis. METHODS: During the past 8 years, 1670 patients with surgically proven appendicitis were identified by a retrospective investigation. Thirty-three patients who underwent contrast-enhanced abdominal CT before surgery and had ascending retrocecal appendicitis at surgery were included in the patient cohort. The clinical and CT findings of these 33 patients were analyzed. RESULTS: Patients presented with right lower abdominal pain (49%, 16/33), right flank pain (24%, 8/33), right upper abdominal pain (18%, 6/33), and periumbilical pain (15%, 5/33). Inflamed ascending retrocecal appendices were visualized completely in 70% (23/33), partially in 21% (7 of 33), and not detected in the remaining 9% (3/33). Periappendiceal inflammatory changes were most commonly observed in the retrocolic space in 88% (29/33), followed by paracolic gutter (30%, 10/33), pararenal space (27%, 9/33), mesentery (24%, 8/33), perirenal space (18%, 6/33), and subhepatic space (3%, 1/33). Inflammatory thickening of Gerota fascia (70%, 23/33) and the lateroconal fascia (64%, 21/33) was observed as well. Perforation of the appendix with the formation of an abscess was present in 49% (16/33). The abscesses were most commonly located in the retrocolic space (88%, 14/16). Diffuse wall thickenings of the cecum (67%, 22/33) and the ascending colon (64%, 21/33) were often observed also. Appendicoliths were found in 33% (11/33). CONCLUSIONS: More than half of patients with ascending retrocecal appendicitis presented with atypical clinical presentation. At CT, ascending retrocecal appendicitis was associated with a high incidence of retroperitoneal inflammatory changes and appendiceal perforation.
AB - OBJECTIVE: To describe the clinical presentation and computed tomographic (CT) features of ascending retrocecal appendicitis. METHODS: During the past 8 years, 1670 patients with surgically proven appendicitis were identified by a retrospective investigation. Thirty-three patients who underwent contrast-enhanced abdominal CT before surgery and had ascending retrocecal appendicitis at surgery were included in the patient cohort. The clinical and CT findings of these 33 patients were analyzed. RESULTS: Patients presented with right lower abdominal pain (49%, 16/33), right flank pain (24%, 8/33), right upper abdominal pain (18%, 6/33), and periumbilical pain (15%, 5/33). Inflamed ascending retrocecal appendices were visualized completely in 70% (23/33), partially in 21% (7 of 33), and not detected in the remaining 9% (3/33). Periappendiceal inflammatory changes were most commonly observed in the retrocolic space in 88% (29/33), followed by paracolic gutter (30%, 10/33), pararenal space (27%, 9/33), mesentery (24%, 8/33), perirenal space (18%, 6/33), and subhepatic space (3%, 1/33). Inflammatory thickening of Gerota fascia (70%, 23/33) and the lateroconal fascia (64%, 21/33) was observed as well. Perforation of the appendix with the formation of an abscess was present in 49% (16/33). The abscesses were most commonly located in the retrocolic space (88%, 14/16). Diffuse wall thickenings of the cecum (67%, 22/33) and the ascending colon (64%, 21/33) were often observed also. Appendicoliths were found in 33% (11/33). CONCLUSIONS: More than half of patients with ascending retrocecal appendicitis presented with atypical clinical presentation. At CT, ascending retrocecal appendicitis was associated with a high incidence of retroperitoneal inflammatory changes and appendiceal perforation.
KW - Appendicitis
KW - Appendix
KW - Computed tomography
KW - Diagnosis
UR - http://www.scopus.com/inward/record.url?scp=33748559457&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33748559457&partnerID=8YFLogxK
U2 - 10.1097/01.rct.0000228151.73528.8f
DO - 10.1097/01.rct.0000228151.73528.8f
M3 - Article
C2 - 16954926
AN - SCOPUS:33748559457
VL - 30
SP - 772
EP - 776
JO - Journal of Computer Assisted Tomography
JF - Journal of Computer Assisted Tomography
SN - 0363-8715
IS - 5
ER -