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

Disclosures

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

In This Article

Bowel Ischemia

Bowel ischemia is a common cause of abdominal pain in the elderly. Helical CT findings include symmetric bowel wall thickening, mucosal thumbprinting, and pneumatosis coli if infarction occurs (Fig. 13). When these findings are localized to the distal ileum, differentiation from acute appendicitis resulting in reactive changes of the ileum may be difficult, especially if a normal appendix is not visualized.

58-year-old man with acute right lower quadrant pain. Axial CT scan shows wall thickening of cecum (C) with pneumatosis ( open arrows ) and pericecal fat stranding ( solid arrows ). Loops of small bowel (S) are dilated, consistent with ileus. Surgery confirmed infarction of cecum.

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