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Upright and supine anteroposterior abdominal radiographs in an infant with

crying and bloody diarrhea for 12 hours show a small bowel obstruction

pattern and little gas in the cecal region

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During contrast enema, note the convex-shaped filling defect of the

intussusceptum, which is reduced to the level of the cecum

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Longitudinal ultrasound of a patient with suspected

intussusception shows the layered bowel walls of the outer

and inner loop, the intussuscipiens, and the intussusceptum

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This vomiting 10-month-old infant has a palpable abdominal

mass. Note the obstruction pattern on plain radiograph and

the intussusceptum in the sigmoid colon on contrast enema

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Radiograph shows a 14-month-old boy with blood in the stool for 3

days. Absent cecal air and an obstruction pattern are seen. Next, the

spot radiograph during an air reduction shows the intussusceptum.

Finally, the reduced intussusception with air in the small bowel is seen

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 A contrast-reduced intussusception shows backward

flow of barium into the small bowel

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Suppurative appendicitis. Circumferential colors in the wall of the inflamed

appendix (arrows), which is a strong indicator of acute appendicitis, is

observed on transverse view of this color Doppler ultrasound image

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 Appendicitis. Normal appendix. Longitudinal ultrasonography

shows compressible tubular structure with an outer diameter

of less than 6 mm (arrows). A=Iliac artery; V=Iliac vein

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 A 15-year-old boy with suppurative appendicitis (same patient as Image

20). Aperistaltic, noncompressible, blind-ended, fluid-filled, tubular

structure with distinct appendiceal wall layers (arrows) arising from the

base of the cecum is observed on the longitudinal ultrasound image

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Phlegmonous appendicitis. Oblique-axial ultrasound view shows

pericecal fluid collection, which is walled off by the small bowel loops

(arrowheads), and the appendicolith with acoustic shadow (arrow).

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Gangrenous appendicitis. Longitudinal ultrasound view shows a markedly

distended appendix (arrows), loss of mucosa and submucosal layers, and

prominent echogenic pericecal fat

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 Appendicitis. Perforated appendix. Longitudinal ultrasound

view shows defect on the tip (large arrow) of the enlarged

appendix (short arrows). c=cecum.

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 Appendicitis. Periappendiceal abscess formation. Oblique-axial ultrasound

image shows a thick-walled complex hypoechoic mass adjacent to the

cecum (arrows). The inflamed appendix was not visualized

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Normal appendix. Complete contrast-filled appendix is observed, which

effectively excludes the diagnosis of appendicitis on barium enema

examination (arrows).

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 A normal appendix, visualized here at the base of the cecum (arrow), isobserved in 44-51% of patients. Thin-section CT scans (5-mm collimation

or less) are more useful in identifying the appendix. Oral or rectal contrast

should be administered. Intravenous contrast is useful in enabling

enhancement and edema of the appendiceal wall to be identified

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The appendix occurs in a retrocecal location in 65% of patients. In

this young female, the appendix extends cranially as far as the

posterior lobe of the liver

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 Arrowhead sign described by Rao indicates contrast outlining the cecum

and funneling into the origin of the appendix, with obstruction of the

lumen preventing retrograde flow of barium into the distal appendix

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 Atypical presentation in a young woman who presented with an elevated

white cell count and right upper quadrant pain. The patient has pericholecystic

fluid and free fluid in the right paracolic gutter, which is caused by retrocecal

appendicitis. The appendix, observed in axial section, is increased in diameter

and has an enhancing thickened wall

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Perforated appendicitis with abscess on CT scan. Note the appendicolith

(arrow) and air within the abscess. The terminal ileum lies anterior to the

appendiceal abscess and inflammatory change is noted in its wall, which

appears thickened (open arrow)

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 Acute suppurative appendicitis. Contrast-enhanced fat-suppressed

T1-weighted spin-echo axial MRI shows a markedly enhanced and

thickened inflamed appendix (arrows). a=Iliac artery; v=Iliac vein;

c=cecum; p=psoas muscle

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 Appendicitis. Periappendiceal abscess. Contrast-enhanced fat-suppressed

T1-weighted spin-echo coronal MRI shows fluid collections (long arrows) and

a markedly enhanced pericecal area (short arrows). c=cecum; b=bladder