What is the role of abdominal radiography in the workup of pediatric appendicitis?

Updated: Oct 25, 2018
  • Author: Adam C Alder, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Abdominal radiography findings are normal in many individuals with appendicitis. However, plain films may be helpful in the setting of severe constipation. A calcified appendiceal fecalith is present in less than 10% of persons with inflammation, but its presence suggests the diagnosis.

Radiographic signs suggestive of appendicitis include convex lumbar scoliosis, obliteration of the right psoas margin, right lower quadrant (RLQ) air-fluid levels, air in the appendix, and localized ileus. In rare incidents, a perforated appendix may produce pneumoperitoneum.

If no other imaging studies are to be performed, an abdominal series may be helpful.

For more information, see the Medscape Reference article Appendicitis Imaging.


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