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

Renal and Urinary Tract Obstruction

Urinary tract disorders commonly present with acute right lower abdominopelvic pain.[5] Occasionally, urine extravasation may occur from the renal collecting system or ureter if the obstruction is acute and severe and may extend into RLQ, resulting in fat stranding mimicking acute appendicitis (Figs. 8A, and 8B). Identifying the normal appendix and tracing the fat stranding back to the urinary tract may help in differentiating this entity from acute appendicitis.

41-year-old man with right lower quadrant (RLQ) pain. A , Axial CT image shows fatty stranding in RLQ ( solid arrows ) surrounding contrast-filled appendix ( open arrow ). B , Axial CT scan obtained superior to A shows dilatation of right renal collecting system ( arrows ) consistent with obstruction. Final diagnosis was right ureteropelvic obstruction.

41-year-old man with right lower quadrant (RLQ) pain. A , Axial CT image shows fatty stranding in RLQ ( solid arrows ) surrounding contrast-filled appendix ( open arrow ). B , Axial CT scan obtained superior to A shows dilatation of right renal collecting system ( arrows ) consistent with obstruction. Final diagnosis was right ureteropelvic obstruction.

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