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

Hemorrhagic Ovarian Cyst

Hemorrhagic ovarian cyst is the most frequent gynecologic condition presenting with lower abdominopelvic pain that may simulate appendicitis, especially when it occurs on the right side. On helical CT, a hemorrhagic ovarian cyst appears as a well-circumscribed structure with attenuation greater than that of simple fluid (Fig. 9). Rupture of the ovarian cyst resulting in free pelvic fluid and/or fat stranding may mimic acute appendicitis. Identification of a normal appendix in conjunction with an ovarian cyst and associated inflammatory changes centered in the adnexa is helpful in establishing the correct diagnosis.

28-year-old woman with acute right lower quadrant pain. Axial CT scan shows cystic structure in right adnexa ( arrows ) with well-defined wall most likely representing hemorrhagic cyst. Follow-up pelvic sonography performed 6 weeks later (not shown) showed interval resolution of cyst.

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