CT appearance of acute appendicitis in childhood

OBJECTIVE. Our objective was to characterize the CT findings in children with acute appendicitis and to compare the CT appearance of the normal and abnormal appendix. MATERIALS AND METHODS. CT scans of 20 children (mean age, 8.6 years old) with surgically proven appendicitis were retrospectively reviewed. The CT studies were evaluated for the presence of a visualized appendix, appendiceal caliber and wall thickness, appendicoliths, pericecal inflammation, and abscess. Fifty children of similar age to the study group who did not have an appendicitis and who had undergone CT scans for acute trauma served as the control population. RESULTS. CT scans revealed the appendix in 25 (50%) of 50 control patients and in 11 (55%) of 20 patients with appendicitis. Appendiceal diameter ranged between 3 and 8 mm (mean, 6 mm) in the control group and between 8 and 12 mm (mean, 10 mm) in patients with appendicitis (p < .05). Wall thickness was barely perceptible in the control population and measured 2-4 mm in patients with appendicitis (p < .05). Appendicoliths were found in 10 (50%) of 20 patients with appendicitis and in none of the control patients. Pericecal inflammation was seen in 19 (95%) of 20 patients with appendicitis and abscess was seen in 10 (50%) of 20 patients. Specific signs of appendicitis, defined as either an inflamed appendix or appendicolith with associated inflammatory changes, were seen in 16 (80%) of 20 patients. CONCLUSION. Our results suggest that CT findings of the healthy appendix are distinct from those of the abnormal appendix and that CT scans can be useful in diagnosing appendicitis in a pediatric population.