There is evidence of mild prominence of the small bowel loops and localized dilated loop in the right iliac fossa along with air fluid level, which may be an indirect sign of appendicitis. This patient was followed up and turned out to be acute appendicitis. Still a lot can be diagnosed on Plain films if you look for them.
Other radiological signs for acute appendicitis: 1) Fluid levels localized to the caecum and terminal ileum, indicating inflammation in the right lower quadrant, 2) Localized ileus with gas in the cecum, ascending colon and terminal ileum, 3) Increased soft tissue density of the right lower quadrant, 4) Blurring of the right flank stripe and presence of a radiolucent line between the fat of the peritoneum and tansverus abdominis, 5) Fecolith in the right iliac fossa, 6) Gas filled appendix, 7) Intraperitoneal gas, 8) Deformity of the cecal gas shadow occurring due to adjacent inflammatory mass and 9) Blurring of the psoas shadow on the right side.
Appendicitis-Plain Film Reviewed by Sumer Sethi on Monday, January 30, 2012 Rating: