Thirty percent of the causes that may induce right lower quadrant (RLQ) pain, are self-limited pathologies that does not require surgery (1, 2). On the other hand, acute appendicitis is the most frequent diagnosis that induces RLQ painand requires surgery. Other reasons of RLQ painare inflammatory (Crohn's Disease, diverticulitis, epiploic appendagitis) or infectious diseases of ileocecal area; benign and malignant tumors; pathologies that affect omentum and mesentery, and the other causes (ischemia, typhlitis) (3-5). Terminal ileum wall (TIW) thickening is an imaging finding that defines...

A retrospective evaluation of PACS in our institution was performed for patients presenting with RLQ pain andterminal ileal wall thickening between December 2008 and August 2011. Patients under 18 years old, CT investigations without contrast administrations and patients with uncertain pathological/clinical diagnosis were excluded. The investigated CT parameters included the length, thickness and symmetricity of thickened segment, the presence of mural enhancement, target sign, mesenteric fat stranding, fluid or abscess in the abdominal cavity. The presence, number and the greatest diameter of local lymph nodes...

The investigation detected 84 patients (51 male, 33 female) that met the inclusion criteria. Clinical/pathological diagnoses of these patients were acute appendicitis (Fig.1) in 25 (29.8%),Crohn’s disease (CD) (Fig.2) in 27 (32.1%) and non-specific ileitis (NSI) (Fig.3) in 32 (38.1%). Demographic data was summarized in Table 1. Table 1: Demographic data distribution according to thediagnoses Acute Appendicitis NSI CD Total Agerange (mean) 19-79 (48.2) 18-72 (40.9) 18-65 (40.6) 18-79 (43.0) Male n (%) 17 (68.0) 15 (46.9) 19 (70.4) 51 (60.7) Female n (%) 8...

The parameters ofterminalileum wall thickness measurement, the number and diameter of involved LN may be used as practical parameters in differential diagnosis of terminal ileum findings in patients presenting with RLQ pain.

Presenting Author: Mustafa SECIL, MD Professor of Radiology Dokuz Eylul University Faculty of Medicine Department of Radiology Izmir - Turkey [email protected]

1) Birnbaum BA, Jeffrey RB, Jr. CT and sonographic evaluation of acute right lower quadrant abdominal pain. AJR Am J Roentgenol. 1998;170(2):361-71. 2) de Dombal FT. Introduction. In: de Dombal FT. ed. Diagnosis of acute abdominal pain, 2nd ed. Edinburgh: Churchill Livingstone; 1991:1-10 3) Purysko AS, Remer EM, Filho HM, Bittencourt LK, Lima RV, Racy DJ. Beyond appendicitis: common and uncommon gastrointestinal causes of right lower quadrant abdominal pain at multidetector CT. Radiographics. 2011;31(4):927-47. 4) Macari M, Balthazar EJ. The acute right lower quadrant: CT...