Helical CT Evaluation of Acute Right Lower Quadrant Pain: Part I, Common Mimics of Appendicitis

Jinxing Yu; Ann S. Fulcher; Mary Ann Turner; Robert A. Halvorsen


Am J Roentgenol. 2005;184(4):1136-1142. 

In This Article

Abstract and Introduction

Objective: The purpose of our pictorial essay is to present common mimics of appendicitis as noted on helical CT in patients with right lower quadrant pain and to highlight the features that provide clues to the diagnosis.
Conclusion: Recognition of the findings of common diseases that simulate acute appendicitis on helical CT, along with features that help to differentiate these entities from appendicitis, is important in establishing a correct diagnosis and in guiding appropriate therapy.

Helical CT plays an important role in the evaluation of patients with right lower quadrant (RLQ) pain and suspected acute appendicitis. Many conditions can produce RLQ pain or inflammatory changes similar to those of acute appendicitis resulting in a diagnostic challenge on CT.[1,2] Common diseases that mimic appendicitis include Crohn's disease, pelvic inflammatory disease, acute pyelonephritis, renal and urinary tract obstruction, hemorrhagic ovarian cyst, right-sided diverticulitis, mesenteric adenitis, epiploic appendagitis, bowel ischemia, right colonic neoplasia, and infectious ileocolitis. Helical CT findings of these common mimics along with features that help to differentiate them from appendicitis are emphasized in these proven cases.


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