By A. Lander

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There has been a shift towards the use of CT in clinical practice with ultrasonography usually being reserved for cases where exposure to ionising radiation is contra indicated. The success of CT is due largely to its ability to visualise the appendix (Friedland & Siegel, 1997). An inflamed appendix usually appears to be larger than 6 mm in diameter and there will also tend to be evidence of inflammatory changes in the surrounding tissues (Choi et al, 2003; Haaga et al, 2003). These changes include the presence of a phlegmon, inflammatory fat stranding, free fluid, abscess formation and in the case of a perforated appendicitis even the presence of small amounts of free air (Haaga et al, 2003).

Ergul E (2007). Heredity and familial tendency of acute appendicitis. Scandinavian Journal of Surgery, 96(4):290-2 Erkasap S, Ates E, Ustuner Z et al (2000). Diagnostic value of interleukin-6 and C-reactive protein in acute appendicitis. 6(4):169-72 Fang YJ, Wang HP, Ho CM et al (2009). Barium appendicitis. Surgery, 146(5):957-8 Fefferman NR, Roche KJ, Pinkney LP et al (2001). Suspected appendicitis in children: focussed CT technique for evaluation. Radiology, 220:691-5 Fraser N, Gannon C, Stringer MD (2004).

6 Table 3. Lengths of the appendix (in cm) (Thyagaraj, 2005) 5. The pathophysiological mechanisms of acute appendicitis It is widely believed that acute appendicitis is the result of an obstruction of the appendiceal lumen, usually by a faecolith (Larner, 1988) but some have found a faecolith only in a minority of cases of acute appendicitis (Chang, 1981). Furthermore, faecoliths need not always cause appendicitis since they have been demonstrated to be present in the appendix in the absence of any inflammation (Fraser, 2004).

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