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Diagnostic Imaging Pathways - Acute Right Iliac Fossa Pain

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Acute Appendicitis

Image 1a (Ultrasound): Dilated, non-compressible appendix with an echogenic appendicolith.

1b Click to view full size image Image 1b and 1c (Computed Tomography): Dilated appendix with appendicolith (arrow).
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2 Click to view full size image Acute Appendicitis

Image 2 (H&E, x2.5): Histological section showing acute suppurative appendicitis. There is ulceration of the mucosa associated with haemorrhage and a dense transmural infiltrate of neutrophils and mononuclear inflammatory cells.

3a Click to view full size image

Ectopic Pregnancy

Image 3a (Ultrasound): Direct demonstration of ectopic foetus (between callipers).

3b Click to view full size image

Image 3b (Ultrasound): Empty endometrial cavity.

4a Click to view full size image Ectopic Pregnancy

Image 4a and 4b (HE, x20). Resection of fallopian tube with an ectopic tubal pregnancy. The histological section shows ulceration of the tubal epithelium, haemorrhage and chorionic villi (arrows) which confirm the presence of products of conception.

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5 Click to view full size image

Crohn's Disease

Image 5 (Computed Tomography with intravenous contrast): Thickened loops of small bowel with stranding of the mesentery.

6 Click to view full size image Crohn's Disease

Image 6: Segmental small bowel resection showing deep linear/serpiginous mucosal ulceration (blue arrow) and a thickened bowel wall with stricture formation (green arrow).


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