X-ray examination of the vermiform appendix

Summary

1. X-ray examination of the appendix may help to lower mistakes in diagnosis. In 10–15 per cent of cases diagnosed as acute appendicitis a normal appendix is removed at operation. The percentage of appendices removed and not giving relief of symptoms in subacute and chronic appendicitis may be 25–70 per cent.

2. Roentgen examination of the appendix will give data concerning anomalies; size, form, shape, and position of the appendix; its mobility; the presence of kinks, congenital bands and adhesions; its peristaltic action; its filling and emptying; the presence of fecaliths, foreign bodies, opaque stones; and the location of tenderness directly upon the appendix; all of which data can’t be obtained through a clinical examination alone.

3. Roentgen examination will disclose secondary signs of early appendiceal disease such as cardio-spasm, pylorospasm, duodenal and ileo-cecal spasm, spasms of both the lower ileum and cecum. Late appendiceal disease will show atony of the lower ileum and cecum with paralytic gaseous distention of the cecum and lower ileum.

4. The technique of roentgen examination of the appendix is given.

5. X-ray findings are discussed in acute, subacute and chronic appendicitis; in appendiceal abscess, tuberculosis of the appendix, diverticula and intussusception, and in both benign and malignant tumors.

6. Reproductions of X-ray findings of appendiceal pathology are shown.