Lesson 1Indications and timing for follow-up imaging and use of ultrasound or MRI in equivocal or pregnant patientsThis section discusses when to perform repeat imaging, how clinical progress influences modality selection, and the use of ultrasound and MRI for unclear, paediatric, or pregnant cases, balancing diagnostic benefits with radiation and contrast safety concerns.
Clinical triggers for repeat imagingUltrasound technique in suspected appendicitisMRI protocols in pregnancy and paediatricsBalancing radiation risk and diagnostic yieldWhen CT remains necessary in pregnancyLesson 2Antibiotic and perioperative considerations tied to imaging findings (e.g., extent of contamination, abscess)This section links CT findings to antibiotic therapy and perioperative planning, assessing contamination levels, abscess extent, and sepsis risks, including surgical timing, prophylaxis options, and treatment duration based on radiologic severity grading.
Imaging predictors of severe contaminationAbscess burden and antibiotic spectrumTiming of surgery after source controlCT guidance for postoperative prophylaxisImaging clues to resistant or atypical infectionLesson 3CT features of complicated appendicitis: perforation, phlegmon, localized abscess, free intraperitoneal air, and small-bowel obstructionThis section reviews CT signs of complicated appendicitis, including perforation, phlegmon, abscess, free air, and small-bowel obstruction, and how to spot subtle indicators that affect intervention urgency and approach in patient management.
Direct and indirect signs of perforationDistinguishing phlegmon from abscessDetection of free intraperitoneal airSmall-bowel obstruction related to appendicitisPredictors of postoperative complicationsLesson 4Measurement and characterization of periappendiceal abscesses: size, loculation, gas, and adjacent bowel involvementThis section covers measuring and describing periappendiceal abscesses on CT, including size, loculation, gas presence, and bowel involvement, and how these details guide drainage options, access paths, and treatment priority in clinical settings.
Standardized abscess size measurementsLoculation, septations, and complexityGas patterns and fistula suspicionAdjacent bowel and organ involvementSelecting candidates for percutaneous drainageLesson 5Contrast-enhanced CT protocols for acute abdomen: oral/IV contrast considerations, phases, and low-dose techniquesThis section details contrast-enhanced CT protocols for acute abdomen, including IV contrast timing, oral contrast use, phase selections, and low-dose methods that maintain diagnostic quality while reducing radiation and contrast-related risks for patients.
IV contrast timing and injection parametersRole of oral contrast in suspected appendicitisSingle versus multiphasic acquisition choicesLow-dose and iterative reconstruction methodsManaging contrast allergy and renal riskLesson 6Reporting format for abdominal CT in acute appendicitis: concise findings, severity grading, and recommended next stepsThis section provides a structured CT reporting framework for suspected appendicitis, highlighting essential components, severity assessment, clear impressions, and practical recommendations to facilitate timely and suitable management in healthcare settings.
Essential elements of the CT reportStandardized severity grading systemsClear impression and diagnostic certaintyActionable management recommendationsCommunicating critical and unexpected findingsLesson 7Interventional radiology and surgical decision-making: indications for percutaneous drainage vs. appendectomy vs. antibiotics-first strategiesThis section explains how CT results shape choices between antibiotics alone, percutaneous drainage, or surgery, considering abscess size, sepsis, patient comorbidities, and collaborative input from radiology, surgery, and interventional teams for optimal care.
CT criteria for antibiotics-first therapyIndications for percutaneous abscess drainageWhen urgent appendectomy is preferredImaging predictors of treatment failurePost-procedure imaging and complication checksLesson 8Primary CT findings of acute appendicitis: appendiceal diameter, wall thickening/enhancement, periappendiceal fat strandingThis section outlines primary CT signs of acute appendicitis, such as appendiceal diameter, wall thickening, enhancement, and fat stranding, including measurement methods and pitfalls that may resemble or conceal the condition in scans.
Measuring appendiceal diameter accuratelyAssessing wall thickening and enhancementCharacterizing periappendiceal fat strandingLuminal obstruction, fecalith, and fluidCommon pitfalls and normal variantsLesson 9CT anatomy of the right lower quadrant: appendix variants, cecum, terminal ileum, mesoappendix, and adjacent structuresThis section reviews right lower quadrant CT anatomy, covering cecum, terminal ileum, mesoappendix, vascular markers, and common appendix positions or variants that influence detection, analysis, and surgical planning in diagnostic evaluations.
Identifying the cecum and ileocecal valveLocating the normal appendix on CTRetrocecal and pelvic appendix positionsMesoappendix, vessels, and lymph nodesCongenital and postsurgical anatomic variantsLesson 10Differentiating appendicitis from mimics: terminal ileitis, Meckel diverticulitis, Crohn disease, epiploic appendagitis, right-sided diverticulitisThis section highlights CT features to differentiate appendicitis from mimics like terminal ileitis, Crohn disease, Meckel diverticulitis, epiploic appendagitis, and right-sided diverticulitis, focusing on wall patterns, location, and fat alterations for precise diagnosis.
Terminal ileitis versus appendicitis on CTCrohn disease activity in the right lower quadrantCT signs of Meckel diverticulitisRecognizing epiploic appendagitisRight-sided colonic diverticulitis features
