Appendix Explained Expert Surgeon Dr Pushkar Galam Causes Symptoms Treatment lifestyle

>> YOUR LINK HERE: ___ http://youtube.com/watch?v=FpiqQs0gwgI

In this radiology lecture, we review the ultrasound appearance of acute appendicitis with three unique cases! • Key teaching points include: • 1) Ultrasound is the first-line imaging modality in pediatric and pregnant patients due to lack of ionizing radiation: Sensitivity/specificity approximately 80%. • 2) Technique: Linear transducer with graded compression at site of maximal tenderness using gradual increased pressure to displace normal bowel gas. • 3) Inflamed appendix appears as a noncompressible, blind-ending tubular structure arising from cecum. • 4) Outer appendiceal diameter with compression: Less than 6 mm almost always normal, 6-8 mm borderline, greater than 8 mm highly suspicious. • 5) Thickened appendiceal wall (greater than 2 mm). • 6) Wall hyperemia: “Dot flow” normal, continuous linear/curvilinear flow highly suspicious. • 7) Increased echogenicity and expansion of peri-appendiceal fat due to infiltration by inflammatory cells and edema. • 8) Hyperechoic appendicolith with posterior acoustic shadowing supportive. • 9) Identify terminal ileum separate from appendix to differentiate from ileitis, Meckel’s diverticulum, or other small bowel abnormality. • 10) Appendix does not exhibit peristalsis. • 11) Right lower quadrant free fluid and lymphadenopathy supportive, but nonspecific in isolation. • 12) Loss of wall stratification suspicious for necrotic/gangrenous appendicitis, and color Doppler flow may be absent. • 13) Gas in appendix appears as dirty shadowing and ring-down artifact. Intraluminal gas sometimes helpful to exclude appendicitis, but can also be seen with gangrenous complication. • 14) Peri-appendiceal gas-containing collections highly suspicious for perforation. CT may be needed for clarification. • References: • 1) Madhuripan N, Jawahar A, Jeffrey RB, Olcott EW. The Borderline-Size Appendix: Grayscale, Color Doppler, and Spectral Doppler Findings That Improve Specificity for the Sonographic Diagnosis of Acute Appendicitis. Ultrasound Q. 2020;36(4):314-320. • 2) Fallon SC, Orth RC, Guillerman RP, et al. Development and validation of an ultrasound scoring system for children with suspected acute appendicitis. Pediatr Radiol. 2015;45(13):1945-1952. • To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-pr... • Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week! • Website: http://www.radiologistHQ.com • Video Podcast: http://bit.ly/radiologistHQ • Instagram: / radiologisthq • Facebook: / radiologistheadquarters • Twitter: / radiologisthq • Reddit: / radiologisthq

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