Accuracy of Noncompressive Sonography of Children with Appendicitis According to the Potential Positions of the Appendix
Matteo Baldisserotto1 and
Edson Marchiori2
1
Departmento de Radiologia, Hospital Criança
Conceição,
Ministério da
Saúde, Av. Francisco Trein, 596, Porto Alegre,
RS, Brazil 91350-200.
2
Departmento de Radiologia do Hospital
Universitário Clementino Fraga Filho da
Universidade Federal do Rio de Janeiro, Rua Thomaz Cameron, 438, 25685-120
Petrópolis, Rio de Janeiro, RJ, Brazil.
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Fig. 1. —Drawing shows positions of appendix during sonography.
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Fig. 2A. —Drawings show positions for assessment of appendix.
Assessment of retrocecal appendix (A): transducer on right flank,
posterior plane, patient in right anterior oblique position; deep pelvic
appendix (B) adjacent to upper posterior wall of urinary bladder:
suprapubic approach with transducer angled cephalad; and deep pelvic appendix
(C) adjacent to right lateral wall of urinary bladder: transducer
angled to the right.
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Fig. 2B. —Drawings show positions for assessment of appendix.
Assessment of retrocecal appendix (A): transducer on right flank,
posterior plane, patient in right anterior oblique position; deep pelvic
appendix (B) adjacent to upper posterior wall of urinary bladder:
suprapublic approach with transducer angled cephalad; and deep pelvic appendix
(C) adjacent to right lateral wall of urinary bladder: transducer
angled to the right.
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Fig. 2C. —Drawings show positions for assessment of appendix.
Assessment of retrocecal appendix (A): transducer on right flank,
posterior plane, patient in right anterior oblique position; deep pelvic
appendix (B) adjacent to upper posterior wall of urinary bladder:
suprapubic approach with transducer angled cephalad; and deep pelvic appendix
(C) adjacent to right lateral wall of urinary bladder: transducer
angled to the right.
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Fig. 3. —Retrocecal appendicitis in 4-year-old boy with intense
abdominal pain. Noncompressive sonogram of right flank with patient in right
anterior position shows retrocecal appendix with pneumoappendix
(arrows). RK = right kidney.
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Fig. 4. —Retrocecal appendicitis in 4-year-old girl with 3-day history
of lumbar pain who was undergoing treatment for urinary infection, and who had
1 day of intense and diffuse abdominal pain and guarding. Noncompressive
sonogram of right flank shows abnormal appendix in ascending retrocecal
position; hyperechoic contents correspond to several fecaliths in its lumen
(arrows). RK = right kidney, L = liver.
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Fig. 5. —Deep pelvic appendicitis in 8-year-old girl with intense
abdominal pain and diarrhea. Noncompressive sonogram through full bladder
shows deep pelvic appendix with hypoechoic content (arrows). B =
bladder.
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Fig. 6. —Deep pelvic appendicitis in 6-year-old-boy with abdominal
pain, guarding, and urinary symptoms. Noncompressive sonogram of pelvis shows
deep pelvic abnormal appendix with isoechoic content (arrows). B =
bladder.
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Fig. 7. —Deep abdominal appendicitis in 4-year-old boy who presented
with considerable pain and abdominal distention. Noncompressive sonogram shows
deeply set appendix (A, arrows) anterior to aorta (Ao). Visualization
of a fecalith (F, arrow) in lumen helped to identify appendix.
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Copyright © 2000 by the American Roentgen Ray Society.
