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    Go to the top of the page   ID: 20051117133349 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Klinik für Kinderchirurgie-Krankenhaus St. Elisabeth und St. Barbara Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    7 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    GI-Large intestine  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    7 year-old boy with slight abdominal discomfort for 10 days. No vomiting, no fever. No other symptoms.
    Abdomen is soft, no localized pain upon pressure.
    Spontaneous pain in the right lower quadrant.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Typical appendicitis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In the first sonographic examination there was a suspicion of appendicitis (images 1-3). The increased size of the internal space, which was larger than the limits of 6 mm and the fact that you could not compress the structure led us to this train of thought. The missing paraclinic and symptoms were factors that led us away from this diagnosis, and we did not operate on the patient and waited 3 days to perform our follow-up examination. Clinically, there was no further or new findings. In the ultrasound, there was an appendix that was less filled (image 4 & 5). In the follow up images (6 & 7), the appendix showed an increase if fullness, but the patient was symptomless. An operation was not yet performed. We have never seen a persistence of this before. In doppler studies, no increased in circulation was seen on any day. Since the appendix was barely compressable and since it did not empty during the examination, we assume that there was a temporary obstruction with spontaneous regression. The option of a laparoscopic appendectomy was agreed upon with the patient's parents if the symptoms persisted.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    appendicitis, appendix, temporary obstruction, abdominal pain, appendix obstruction, appendectomy, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: GI-Large intestine
    or in the region: GI
    or in the tissue/organ: Large intestine
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

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    Temporary Obstruction of the Appendix
    Other cases by these authors:

    Search Dirk Schaper in Medline Dirk Schaper (43)   

    Temporary Obstruction of the Appendix  
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

    Which diagnosis have other collegues guessed?


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (6 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (62 %)


    • Meckel's Diverticulum
      Votes: 5 (31 %)



        Total answers: 16

     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

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    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     




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