Photo Quiz: Sudden Onset of Right Lower Quadrant Pain After Heavy Exercise

摘要

A radiopaque fecalith is visible in the right lower quadrant in fewer than 5 percent of patients with acute appendicitis.3 The most suggestive CT findings of appendicitis are an inflamed appendix (larger than 6 mm in diameter), appendiceal wall thickening with wall enhancement, and periappendiceal inflammatory changes.3 Gastrointestinal bezoar (poorly digested fruit or vegetable fiber, hair, or both) may occasionally cause intestinal obstruction. CT may show the foreign body itself, as well as signs of inflammation following perforation (e.g., intestinal wall thickening, localized pneumoperitoneum, regional fat stranding, intestinal obstruction).5 A calcified shadow in the right lower abdomen visible on plain radiography may suggest ureterolithiasis in a patient with hematuria and abdominal pain.