Imaging studies to diagnosis appendicitis
An abdominal x-ray may detect the fecalith (the hardened and calcified, pea-sized piece of stool that blocks the appendiceal opening) that may be the cause of appendicitis. This is especially true in children. Nevertheless, the presence of a fecalith can occur without appendicitis.
An ultrasound is a painless procedure that uses sound waves to provide images to identify organs within the body. Ultrasound can identify an enlarged appendix or an abscess. Nevertheless, during appendicitis, an enlarged inflamed appendix or abscess can be seen in only 50% of patients. Therefore, not seeing the appendix during an ultrasound does not exclude appendicitis. Ultrasound also is helpful in women because it can exclude the presence of conditions involving the ovaries, Fallopian tubes and uterus (pelvic inflammatory disease, PID) that can mimic appendicitis.
A barium enema is an X-ray test in which liquid barium is inserted into the colon from the anus to fill the colon. This test can, at times, show an impression on the colon in the area of the appendix where the inflammation from the adjacent inflammation impinges on the colon. Barium enema also can exclude other intestinal problems that mimic appendicitis, for example Crohn's disease.
Computerized tomography (CT) scan
In patients who are not pregnant, a CT scan (a type of X-ray study) of the area of the appendix is useful in diagnosing appendicitis and peri-appendiceal abscesses as well as in excluding other diseases inside the abdomen and pelvis that can mimic appendicitis.
Laparoscopy is a surgical procedure in which a small fiberoptic tube with a camera is inserted into the abdomen through a small puncture made on the abdominal wall. Laparoscopy allows a direct view of the appendix as well as other abdominal and pelvic organs. If appendicitis is found, the inflamed appendix can be removed with the laparoscope. The disadvantage of laparoscopy compared to ultrasound and CT is that it requires a general anesthetic.
There is no one test that will diagnose appendicitis with certainty. Therefore, the approach to suspected appendicitis may include a period of observation, tests as previously discussed, or surgery.
Hi,Like others users I found this message board by googling for chronic appendicitis.After reading it I'm still not sure whether I should worry or not.I've had this lower right abdomen discomfort for a couple of months now. It manifests as a migratory, deep pain (feels more like a sting), anywhere between the belly button, the hip bone and pubis. The pain comes and goes, but one area which is always sensitive to pressure (e.g. crouching or bringing the leg up) is the lower right abdomen. Occasionally I also have mild stomach pain (like I have not eaten).No nausea, vomiting or any typical simptoms (only a few episodes of mild fever). The pain itself is never severe enough to wake me up in the middle of the night or send me to the emergency room, but is is annoying enough to interefere at times with my work and well being. I've had a couple of tests done (blood, urine, stools) as well as an ultrasound scan. Liver functions are normal, kidneys ok, prostate and bladder as well. No signs of hernia or any other kind of damage. The ultrasound itself revealed small gallstones, but nothing else abnormal (the appendix however could not be seen due to gas blocking the sound path). I discussed the results with both my GP and a general surgeon, and they maintain that gallstones could not be responsible for these symptoms. They also rule out appendicitis because the symptoms do not match (although they both admitted that the area I point to is around the appendix).Honestly I don't know where to go from here, and I would like to shake off the abdominal pain/discomfort one way or another. Any suggestions?Cheers,Alan