Acute appendicitis – US

Acute appendicitis on Ultrasound. US of the right iliac fossa is a good first line imaging test for acute appendicitis, particularly in female patients (where it is often combined with imaging of the pelvis, to assess for alternative causes of symptoms such as an ovarian cyst). It has a high sensitivity in slim patients, however it is much more difficult to identify the appendix in the obese. What we look for is a blind-ending tubular structure (we need to see that it’s blind-ending, to be sure that it isn’t small bowel that we’re looking at) that measures more than 6 mm in thickness, as demonstrated in this example of surgically-confirmed acute appendicitis.