Editing Appendicitis (section)

====Ultrasound====
[[File:SonoAppendizitis.JPG|thumb|An [[ultrasound]] image of acute appendicitis in December 2008]]
[[Abdominal ultrasonography]], preferably with [[doppler sonography]], is useful to detect appendicitis, especially in children. Ultrasound can show the free fluid collection in the right iliac fossa, along with a visible appendix with increased blood flow when using color Doppler, and noncompressibility of the appendix, as it is essentially a walled-off abscess. Other secondary sonographic signs of acute appendicitis include the presence of echogenic mesenteric fat surrounding the appendix and the acoustic shadowing of an appendicolith.<ref name="ReferenceA">{{cite journal | vauthors = Reddan T, Corness J, Mengersen K, Harden F | title = Ultrasound of pediatric appendicitis and its secondary sonographic signs: providing a more meaningful finding | journal = Journal of Medical Radiation Sciences | volume = 63 | issue = 1 | pages = 59–66 | date = March 2016 | pmid = 27087976 | pmc = 4775827 | doi = 10.1002/jmrs.154 | author3-link = Kerrie Mengersen }}</ref> In some cases (approximately 5%),<ref>{{cite journal|vauthors=Reddan T, Corness J, Mengersen K, Harden F|title=Sonographic diagnosis of acute appendicitis in children: a 3-year retrospective|journal=Sonography|volume=3|issue=3|pages=87–94|date=June 2016|doi=10.1002/sono.12068|s2cid=78306243|doi-access=free}}</ref> ultrasonography of the [[iliac fossa]] does not reveal any abnormalities despite the presence of appendicitis. This false-negative finding is especially true of early appendicitis before the appendix has become significantly distended. Also, false-negative findings are more common in adults where larger amounts of fat and bowel gas make visualizing the appendix technically difficult. Despite these limitations, sonographic imaging with experienced hands can often distinguish between appendicitis and other diseases with similar symptoms. Some of these conditions include [[inflammation]] of [[lymph nodes]] near the appendix or pain originating from other pelvic organs such as the ovaries or Fallopian tubes. Ultrasounds may be either done by the radiology department or by the emergency physician.<ref>{{cite journal |last1=Lee |first1=Sun Hwa |last2=Yun |first2=Seong Jong |title=Diagnostic performance of emergency physician-performed point-of-care ultrasonography for acute appendicitis: A meta-analysis |journal=The American Journal of Emergency Medicine |date=April 2019 |volume=37 |issue=4 |pages=696–705 |doi=10.1016/j.ajem.2018.07.025 |pmid=30017693|s2cid=51677455 }}</ref>

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File:UOTW 45 - Ultrasound of the Week 1.webm|Ultrasound showing appendicitis and an appendicolith<ref name=UOTW45>{{cite web|title=UOTW #45 - Ultrasound of the Week|url=https://www.ultrasoundoftheweek.com/uotw-45/|website=Ultrasound of the Week|date=25 April 2015|url-status=live|archive-url=https://web.archive.org/web/20170509131322/https://www.ultrasoundoftheweek.com/uotw-45/|archive-date=9 May 2017}}</ref>
File:UOTW 45 - Ultrasound of the Week 3.jpg|Ultrasound showing appendicitis and an appendicolith<ref name=UOTW45/>
File:Ultrasonography of a normal appendix, annotated.jpg|Ultrasound of a normal appendix for comparison
File:Ultrasonography of a normal appendix without and with compression.jpg|A normal appendix without and with compression. Absence of compressibility indicates appendicitis.<ref name="ReferenceA"/>
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