Ultrasound has a sensitivity of 78% and a specificity of 83%. Ultrasound abdomen and pelvis is the second most common imaging modality used in patients presenting with acute abdominal pain in whom there is a degree of clinical uncertainty. The presence of other features such as appendiceal wall defect, extraluminal air or localised abscess is more suggestive of a perforated appendix. ![]() Ĭlassical features suggestive of appendicitis on CT include concentric and thickened appendiceal wall, the presence of an appendicolith, fat stranding, mesenteric lymphadenopathy and the presence of surrounding fluid. The most common imaging modality used in patients with right-sided abdominal pain is abdominal and pelvic CT, which has a sensitivity of 97% and a specificity of 98%. The use of imaging in those circumstances not only aids in ruling in the diagnosis of acute appendicitis but also helps in differentiating other forms of pathology contributing to patient’s symptoms. The use of imaging modalities such as abdominal and pelvic ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) can be crucial in assessing those equivocal cases with vague nonspecific symptoms. ![]() It is very important to consider those mimics when assessing patients presenting to the emergency department (ED) with acute right-sided abdominal pain. Those conditions include a variety of gastrointestinal, vascular, genitourinary and gynaecological diseases. Although acute appendicitis is one of the most common causes for acute surgical abdomen accounting for 250,000 appendectomies in the United States every year, a large number of other clinical conditions can mimic the presentation of this acute surgical emergency.
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