Findings, case of 29 y/o woman, nausea, vomiting and abdominal pain

Imaging Findings

Supine and upright plain radiographs of the abdomen show a relative paucity of bowel gas on the left side of the abdomen. There is mild irregularity and thickening of the folds in a loop of bowel in the right lower quadrant (arrow). Several gas-fluid levels are seen in this region (arrows). No appendicolith or free intraperitoneal air is seen. These findings are consistent with an inflammatory process in the right lower quadrant resulting in a localized small bowel ileus.

Ultrasound shows a thick-walled, non-compressible tubular structure in the right lower quadrant arising from the cecum (arrow). It measures 2.2 cm in its outer anteroposterior diameter and represents an inflamed appendix (arrow). A small amount of periappendiceal fluid (arrow) may represent a possible perforation. No appendicolith or periappendiceal abscess is visible. The uterus and ovaries are normal.

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