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While looking through the archives of ultrasound images I came across a couple of instances of common diagnoses made through tests that are not commonly done to diagnose them. This might become a series of posts, if I stick with the theme.

Acute Appendicitis is, as everyone knows, a common diagnosis on ultrasonography of the Abdomen (TAS = Transabdominal sonography).

Rarely we do get to see a classical appendicolith on ultrasonography.

What is quite rare is this…

Finding an acutely inflammed Appendix during Transvaginal Ultrasonography (TVS, also called EVS - Endovaginal sonography) done to rule out a pelvic cause for Acute Abdominal pain.

While I only diagnosed Appendicitis through the transvaginal route, there are surgeons in India and the USA who have removed the inflammed Appendix through the vagina!! The Indian surgeons, who as per the PubMed abstract, were the first in the world to attempt this, are from my hometown Coimbatore.

Further Reading:

An interesting article on the History of Appendicitis Vermiformis by Prof. Arthur C. McCarty, MD can be found here.

Wikipedia article on Acute Appendicitis.

Learning Radiology article on Appendicitis.

BrighamRad article on Appendicitis, which gives a textbook description of the ultrasound findings in acute appendicitis - as found in the abstract of this older article in the Journal of Ultrasound in Medicine.

Scalpel’s post on Appendicolith.

YouTube video of Acute Appendicitis with fecolith (via the above-mentioned post by Scalpel)

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