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

Pelvic Inflammatory Disease

Pelvic inflammatory disease represents a spectrum of infection within the female reproductive system. Hydrosalpinx, especially when involvement is limited to the right fallopian tube, may be confused with a dilated appendix on CT (Figs. 6A, and 6B). The extrinsic inflammation from a tuboovarian abscess, if it lies adjacent to the appendix, may cause serosal edema and mural thickening of the appendix, which create a diagnostic challenge. Recognizing that the inflammation is centered in the adnexa rather than in the appendix assists in making the correct diagnosis.

34-year-old woman with acute right lower quadrant pain. A , Axial CT scan shows dilated tubular fluid-density structure in right adnexa ( arrows ) medial to cecum (C) consistent with right hydrosalpinx. B , Axial CT scan obtained inferior to A shows fat stranding ( open arrows ) surrounding right ovary (O). Physical examination showed vaginal discharge and cervical motion tenderness consistent with pelvic inflammatory disease. Uterus (U) is noted.

34-year-old woman with acute right lower quadrant pain. A , Axial CT scan shows dilated tubular fluid-density structure in right adnexa ( arrows ) medial to cecum (C) consistent with right hydrosalpinx. B , Axial CT scan obtained inferior to A shows fat stranding ( open arrows ) surrounding right ovary (O). Physical examination showed vaginal discharge and cervical motion tenderness consistent with pelvic inflammatory disease. Uterus (U) is noted.

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