Page 23 Flashcards
What is the imaging of choice in men and older patients?
CT
What is the best imaging modality if a periappendiceal abscess is suspected?
CT
How do you differentiate a soft tissue mass versus abscess on CT?
Soft tissue mass >20 HU, abscess <20HU
How are abscesses treated based on their size?
> 3cm-drainage, <3cm-antibiotics
What are the CT findings of AP?
Dilated appendix >6mm, enhancing appendix, surrounding inflammatory stranding or abscess, pericecal abscess or inflammatory mass with appendicolith
What are MRI findings of AP? (aside from dilated appendix)
Periappendiceal inflammation-high T2 fs, appendicolith-area of low signal within the lumen, periappendiceal phlegmon or fluid collection-high T2
What are the causes of mucocele formation in the appendix?
Obstruction by appendicolith, foreign body, adhesions, tumor
*mucocele: US; onion sign
What does a mucocele of the appendix look like?
Large (up to 15cm), well-defined cystic mass in RLQ
What findings are suggestive of mucocele of the appendix?
Appendiceal dilatation >13mm +- peripheral calcificatio
What is a complication of rupture of appendiceal mucocele?
May cause pseudomyxoma peritonei. Gelatinous implants may spread in peritoneal cavity and cause adhesions, mucinous ascites
What are the common appendiceal tumors?
Carcinoid, adenoma, adenocarcinoma
What is the most common tumor of the appendix?
Carcinoid (85%)
What is the most common location for carcinoid tumor?
Appendix (60% of all carcinoids)
How do you differentiate carcinoid from appendix versus elsewhere in GI?
Usually solitary, less tendency to metastasize, no carcinoid syndrome, no mesenteric reaction
Signs of impending rupture of aortic aneurysm
draped aorta sign, high-attenuation crescent sign, and focal discontinuity of intimal calcification
