25/05/2025
This image is an ultrasound-based depiction of various stages and complications of appendicitis, progressing from acute inflammation to perforation and abscess formation. Here's a breakdown of each labeled condition:
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A. Acute Appendicitis
Ultrasound appearance: Tubular, non-compressible, blind-ended structure with thickened wall.
Diameter: 0.9 cm (above normal threshold of 6 mm).
Features: Wall thickening, increased echogenicity of surrounding fat (not shown here), often tender with probe pressure.
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B. Gangrenous Appendicitis
Ultrasound appearance: Increased diameter (1.5 cm), loss of normal wall layers, hypoechoic center.
Features: Wall necrosis, decreased vascularity on Doppler (not shown), possibly gas within wall or lumen.
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C. Appendicitis with Appendicolith
Ultrasound appearance: Hyperechoic focus with posterior acoustic shadowing (classic sign of appendicolith).
Features: Increased risk of perforation, often associated with more severe inflammation.
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D. Perforated Appendix with Abscess
Ultrasound appearance: Loss of defined appendix border, surrounding heterogeneous collection with internal echoes (suggestive of abscess).
Features: Fluid collection, localized or generalized peritonitis, complex fluid or gas bubbles may be visible.
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Clinical Relevance
Ultrasound is particularly useful in pediatric and pregnant patients.
Progressive increase in diameter and complexity of findings correlates with disease severity.
Identification of appendicoliths and abscess formation helps guide surgical vs. conservative management.
