Although acute appendicitis is thought to be result from luminal obstruction of the appendix, rarely it may develop following abdominal trauma. Traumatic appendicitis is thought to occur through direct injury to the appendix, or as a response to other abdominal organ injury. On the other hand, in patients with other organ injury, some distension of the appendix can occur with surrounding free fluid secondary to trauma, mimicking appendicitis. While the clinical presentation of traumatic appendicitis is similar to that of traditional appendicitis, differentiation between reactive appendiceal changes in the setting of traumatic injury to other intra-abdominal organs is important, as the latter will not require appendectomy. We present two pediatric patients in whom following initial suspicion of acute appendicitis, ultrasonography (US) identified mildly enlarged fluid-filled and hyperemic appendix with out of proportion complex fluid, raising the suspicion of previously unsuspected abdominal trauma. Upon further examination, injury to other abdominal solid organs was discovered as the primary cause of patient's presentation and appendiceal findings were reactive to abdominal solid organ injury. In cases of suspected appendicitis, visualization of significant free fluid with dense debris on ultrasonography (US) calls for more careful examination to assess clues of other abdominal injury. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Tong Jane, Luo Yu

Keywords: reactive appendicitis, abdominal trauma, ultrasound