Leonard Edward Swischuk MD, Presenter: Nothing to Disclose

Dai Chung MD, Abstract Co-Author: Nothing to Disclose

Hal Hawkins MD, Abstract Co-Author: Nothing to Disclose

Diana Maria Palacio MD, Abstract Co-Author: Nothing to Disclose

Siddharth Prafull Jadhav MD, Abstract Co-Author: Nothing to Disclose

To evaluate the role of lymphoid hyperplasia of the appendix in the development of purulent appendicitis limited to the appendiceal tip.

We reviewed the imaging and histologic findings in 40 cases of histologically proven purulent appendicitis seen over two years. Findings documented were: (1) appendiceal tip involvement, (2) total appendiceal involvement, (3) presence of a fecalith, and (4) presence of lymphoid hyperplasia.

There were a total of forty patients, twenty-eight males and twelve females. The age range was 2-18 years with a mean of 11.5 years. Twenty (22) patients demonstrated classic total appendiceal purulent appendicitis. Twenty (20) had a fecalith. Eighteen (18) patients had purulent appendicitis confined to the tip of the appendix. All eighteen (18) patients demonstrated marked lymphoid hyperplasia. Only two (2) had a fecalith.

Lymphoid hyperplasia seems to play a significant role in the development of acute purulent appendicitis of the appendiceal tip and is not associated with intraluminal fecalith obstruction.

This form of appendicitis has the potential of being treated non-surgically with antibiotics. Its identification, on the basis of imaging findings can be accomplished with confidence.

Swischuk, L, Chung, D, Hawkins, H, Palacio, D, Jadhav, S, Appendicitis of the Tip of the Appendix: Role of Viral-induced Lymphoid Hyperplasia.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8005199.html