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Appendicitis

Dr. Oron Frenkel

A blind-ended, non-compressible tubular structure combined with a focal tenderness suggests appendicitis.

Specialties: Emergency Medicine, Hospitalist, Pediatrics, Primary Care, Rural
Applications: Abdomen, Small Part
in this video we see the linear scanner on a small parts preset placed in a transverse or oblique plane in the right lower quadrant of a patient who's presenting with abdominal pain and immediately coming into view are the superficial layers of the abdominal wall musculature here's the peritoneum and here is a tubular structure that is non-compressible as the scanner is providing and applying pressure scanning down the length to see what this object is it's not compressing with pressure and surrounding it is some free fluid that is visualizable here as anechoic material the object it can be scanned to see roughly its diameter and where it's going from its entry to its exit point in the setting of a suspected appendicitis as is shown here the transducer is rotated to see the entire length of it coming down to a blind ended pouch down here other findings that are considered secondary findings of appendicitis would be the free fluid that was seen and here is some hyperechoic fat surrounding the appendix and then the length of the appendix can be scanned back towards its entry here you can see clearly that its maximal diameter is likely approximating one centimeter as demarcated here by the depth gauge on the screen and we can see how far the appendix goes to confirm that it is blind ended non-compressible dilated tubular appearing structure in the right lower quadrant particularly absent in this video would be whether it was the point of maximal pain for this patient but it is highly suspicious as it also looks like it connects over here to the dirty shadowing of the colon and cecum really suggesting this is true appendicitis

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