PURPOSE: The purpose of this study was to evaluate the ultrasonographic findings of secondary appendicitis (SA) and to discuss the differential findings compared with primary appendicitis. METHODS: In this study, we analyzed the ultrasonographic findings of 94 patients under 15 years old of age treated at our institution from May 2005 to May 2014 who had bowel inflammation and an inflamed appendix with a maximal outer diameter >6 mm that improved with nonsurgical treatment (the SA group). Ninety-nine patients with pathologically proven acute appendicitis (the primary appendicitis [PA] group) from June 2013 to May 2014 and 44 patients with pathologically negative appendectomy results from May 2005 to May 2014 were also included to compare the ultrasonographic features of these conditions. A retrospective review of the ultrasonographic findings was performed by two radiologists. The clinical and laboratory findings were also reviewed. The results were statically analyzed using analysis of variance, the Pearson chi-square test, and the two-tailed Fisher exact test. RESULTS: Compared with PA, cases of SA had a smaller diameter (9.8 mm vs. 6.6 mm, P < 0.001), and were less likely to show periappendiceal fat inflammation (98% vs. 6%, P < 0.001) or an appendicolith (34% vs. 11%, P < 0.001). SA showed mural hyperemia on color Doppler ultrasonography as frequently as PA (P=0.887). CONCLUSION: The ultrasonographic features of SA included an increased diameter compared to a healthy appendix and the same level of hyperemia as in PA. However, the diameter was commonly in the equivocal range (mean diameter, 6.6 mm), and periappendiceal fat inflammation was rarely present in SA.
Appendectomy ; Appendicitis* ; Appendix ; Humans ; Hyperemia ; Inflammation ; Pediatrics ; Retrospective Studies ; Ultrasonography* ; Ultrasonography, Doppler, Color

No abstract available.
Arteries*

Ultrasonography (US) is a sensitive and radiation-free technique for diagnosing deep vein thrombosis (DVT). Therefore, when DVT is clinically suspected but not detected on US, radiologists should consider a range of alternative differential diagnoses. This review article presents the imaging findings of clinical conditions that mimic DVT, which can be distinguished using a multimodal radiologic approach. Additionally, DVT mimics can be categorized into two groups based on whether a flat or normal waveform is observed on Doppler US. This article details the imaging findings and clinical presentations of DVT mimics, organized by these classifications. This information may help radiologists make more accurate diagnoses, enabling patients to receive appropriate treatment in a timely manner.

Ultrasonography (US) is a sensitive and radiation-free technique for diagnosing deep vein thrombosis (DVT). Therefore, when DVT is clinically suspected but not detected on US, radiologists should consider a range of alternative differential diagnoses. This review article presents the imaging findings of clinical conditions that mimic DVT, which can be distinguished using a multimodal radiologic approach. Additionally, DVT mimics can be categorized into two groups based on whether a flat or normal waveform is observed on Doppler US. This article details the imaging findings and clinical presentations of DVT mimics, organized by these classifications. This information may help radiologists make more accurate diagnoses, enabling patients to receive appropriate treatment in a timely manner.

Ultrasonography (US) is a sensitive and radiation-free technique for diagnosing deep vein thrombosis (DVT). Therefore, when DVT is clinically suspected but not detected on US, radiologists should consider a range of alternative differential diagnoses. This review article presents the imaging findings of clinical conditions that mimic DVT, which can be distinguished using a multimodal radiologic approach. Additionally, DVT mimics can be categorized into two groups based on whether a flat or normal waveform is observed on Doppler US. This article details the imaging findings and clinical presentations of DVT mimics, organized by these classifications. This information may help radiologists make more accurate diagnoses, enabling patients to receive appropriate treatment in a timely manner.

Total gastrectomy with Roux-en-Y esophagojejunostomy is a common surgical treatment for early gastric cancer; however, postoperative complications such as anastomotic leaks remain a serious risk. This report details a 59-year-old female who underwent total gastrectomy with Roux-en-Y esophagojejunostomy for early gastric cancer, followed by percutaneous embolization for esophagojejunal (EJ) anastomotic leakage. Despite initial percutaneous drainage for fluid accumulation at the EJ site, subsequent CT revealed significant anastomotic dehiscence. Endoscopic treatment was ineffective and surgical intervention posed a high risk of mortality; therefore, percutaneous embolization was requested. This involved four sessions using cut gel foam, N-butyl-2-cyanoacrylate, and lipiodol. The procedure was successful without complications and led to complete resolution of the leakage and dehiscence. Follow-up CT scans at 6- and 32-months post-procedure confirmed the absence of recurrence. This case highlights the potential of percutaneous embolization as a treatment option for anastomotic leakage after Roux-en-Y esophagojejunostomy.

Total gastrectomy with Roux-en-Y esophagojejunostomy is a common surgical treatment for early gastric cancer; however, postoperative complications such as anastomotic leaks remain a serious risk. This report details a 59-year-old female who underwent total gastrectomy with Roux-en-Y esophagojejunostomy for early gastric cancer, followed by percutaneous embolization for esophagojejunal (EJ) anastomotic leakage. Despite initial percutaneous drainage for fluid accumulation at the EJ site, subsequent CT revealed significant anastomotic dehiscence. Endoscopic treatment was ineffective and surgical intervention posed a high risk of mortality; therefore, percutaneous embolization was requested. This involved four sessions using cut gel foam, N-butyl-2-cyanoacrylate, and lipiodol. The procedure was successful without complications and led to complete resolution of the leakage and dehiscence. Follow-up CT scans at 6- and 32-months post-procedure confirmed the absence of recurrence. This case highlights the potential of percutaneous embolization as a treatment option for anastomotic leakage after Roux-en-Y esophagojejunostomy.

Ultrasonography (US) is a sensitive and radiation-free technique for diagnosing deep vein thrombosis (DVT). Therefore, when DVT is clinically suspected but not detected on US, radiologists should consider a range of alternative differential diagnoses. This review article presents the imaging findings of clinical conditions that mimic DVT, which can be distinguished using a multimodal radiologic approach. Additionally, DVT mimics can be categorized into two groups based on whether a flat or normal waveform is observed on Doppler US. This article details the imaging findings and clinical presentations of DVT mimics, organized by these classifications. This information may help radiologists make more accurate diagnoses, enabling patients to receive appropriate treatment in a timely manner.

Total gastrectomy with Roux-en-Y esophagojejunostomy is a common surgical treatment for early gastric cancer; however, postoperative complications such as anastomotic leaks remain a serious risk. This report details a 59-year-old female who underwent total gastrectomy with Roux-en-Y esophagojejunostomy for early gastric cancer, followed by percutaneous embolization for esophagojejunal (EJ) anastomotic leakage. Despite initial percutaneous drainage for fluid accumulation at the EJ site, subsequent CT revealed significant anastomotic dehiscence. Endoscopic treatment was ineffective and surgical intervention posed a high risk of mortality; therefore, percutaneous embolization was requested. This involved four sessions using cut gel foam, N-butyl-2-cyanoacrylate, and lipiodol. The procedure was successful without complications and led to complete resolution of the leakage and dehiscence. Follow-up CT scans at 6- and 32-months post-procedure confirmed the absence of recurrence. This case highlights the potential of percutaneous embolization as a treatment option for anastomotic leakage after Roux-en-Y esophagojejunostomy.

Ultrasonography (US) is a sensitive and radiation-free technique for diagnosing deep vein thrombosis (DVT). Therefore, when DVT is clinically suspected but not detected on US, radiologists should consider a range of alternative differential diagnoses. This review article presents the imaging findings of clinical conditions that mimic DVT, which can be distinguished using a multimodal radiologic approach. Additionally, DVT mimics can be categorized into two groups based on whether a flat or normal waveform is observed on Doppler US. This article details the imaging findings and clinical presentations of DVT mimics, organized by these classifications. This information may help radiologists make more accurate diagnoses, enabling patients to receive appropriate treatment in a timely manner.