title: Non-fecalith-induced appendicitis: etiology, imaging, and pathology.
abstract: This study aims to document the imaging and pathology findings in non-fecalith-induced appendicitis. We reviewed the imaging and pathologic findings in 40 patients with histologically proven purulent appendicitis seen over a 2-year period. Findings documented were (1) total appendiceal involvement, (2) predominant appendiceal tip involvement, (3) presence of a fecalith, and (4) presence of lymphoid hyperplasia. There were a total of 40 patients, 28 males and 12 females. The age range was 2-18 years with a mean of 11.5 years. Twenty-two (55 %) patients demonstrated classic purulent appendicitis of the whole appendix, 20 (91 %) of these appendices had a fecalith. Eighteen (45 %) patients demonstrated purulent appendicitis confined to or predominately involving the tip of the appendix, and all 18 (100 %) patients demonstrated marked lymphoid hyperplasia. Only two (11 %) of these appendices had a fecalith. Overall, a fecalith was found in only 55 % of our cases, while 45 % demonstrated no fecalith, but rather marked lymphoid hyperplasia. Lymphoid hyperplasia appeared to be the underlying predisposing cause of purulent appendicitis in these cases.
authors: Department of Radiology and Pediatrics, The University of Texas Medical Branch, Galveston, TX, USA. lswischu@utmb.edu.
authors: Leonard E
authors: LE
authors: Swischuk
authors: Department of Pediatric Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
authors: Dai H
authors: DH
authors: Chung
authors: Department of Pathology, the University of Texas Medical Branch, Galveston, TX, USA.
authors: Hal K
authors: HK
authors: Hawkins
authors: Department of Radiology, Texas Children's Hospital, Houston, TX, USA.
authors: Siddharth P
authors: SP
authors: Jadhav
authors: Department of Surgery-General Surgery, The University of Texas Medical Branch, Galveston, TX, USA.
authors: Ravi
authors: R
authors: Radhakrishnan
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005244:Fecal Impaction / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008232:Lymphoproliferative Disorders / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography
keywords: Appendicitis; Imaging; Lymphoid hyperplasia