Question 1588
{"accessible":true,"alternatives":[{"id":7909,"text":"cecitis"},{"id":7910,"text":"localized peritonitis"},{"id":7911,"text":"mesenteric adenitis"},{"id":7912,"text":"periappendiceal abscess"},{"id":7913,"text":"vascular recruitment"}],"archived":false,"correctAlternativeId":7910,"explanation":"\u003cp\u003eOne of the potential findings with\u0026nbsp;\u003ca href=\"/articles/appendicitis-2\"\u003eacute appendicitis\u003c/a\u003e is \u003cstrong\u003eperitonitis\u003c/strong\u003e. This is usually localized to the right lower quadrant around the appendix - as in this case - and presents on CT as a mildly thickened and enhancing peritoneal lining (red arrow). If the\u0026nbsp;infection/inflammation spreads throughout the peritoneal space, then generalized peritonitis may occur. Peritonitis can occur both with and without perforation, so is not a reliable sign of perforation.\u003c/p\u003e\u003cp\u003eThere is no discrete fluid collection at the red arrow, so this would not be a periappendiceal\u0026nbsp;abscess. The cecum is located above the structure at the red arrow. Inflammation recruits blood flow, but this is not a common finding on appendicitis and is more commonly encountered in acute colonic diverticulitis or ileitis such as Crohn disease (\"comb sign\"). Mesenteric adenitis refers to inflamed regional lymph nodes.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eImage credit:\u0026nbsp;\u003c/strong\u003eMatthew A Morgan\u003c/p\u003e","id":1588,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/121/RLQ_pain_-_annoted_big_gallery.jpeg","imageAttribution":{"kind":"own","user_id":35959,"user_param":"crushergradient","user_name":"Matt A. Morgan"},"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2640","nextQuestionPath":"/articles/acute-appendicitis-2/questions/546","relatedArticles":[{"id":2234,"title":"Typhlitis","link":"/articles/typhlitis?lang=us"},{"id":13067,"title":"Mesenteric adenitis","link":"/articles/mesenteric-adenitis?lang=us"},{"id":24241,"title":"Appendicular abscess","link":"/articles/appendicular-abscess?lang=us"}],"alsoUsedIn":[{"id":238,"kind":"Course","title":"Right lower quadrant pain: a survival guide","link":"https://radiopaedia.org/courses/right-lower-quadrant-pain-a-survival-guide"},{"id":980,"kind":"Course","title":"2021 Virtual Conference Private Use - page 980","link":"https://radiopaedia.org/courses/2021-virtual-conference-private-use/pages/980"},{"id":980,"kind":"Course","title":"2022 Virtual Conference Private Use - page 980","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/980"},{"id":970,"kind":"RestrictedPage","title":"Page 970 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/970"},{"id":955,"kind":"RestrictedPage","title":"Page 955 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/955"},{"id":1,"kind":"LiveSchedule","title":"1","link":"https://radiopaedia.org/admin/live_schedules/1"},{"id":8,"kind":"LiveSchedule","title":"8","link":"https://radiopaedia.org/admin/live_schedules/8"},{"id":603,"kind":"Course","title":"Lectures by Matt A Morgan - page 603","link":"https://radiopaedia.org/courses/lectures-by-matt-a-morgan/pages/603"},{"id":603,"kind":"Course","title":"Radiopaedia 2020 - Lectures Only - page 603","link":"https://radiopaedia.org/courses/radiopaedia-2020-exclusive/pages/603"},{"id":603,"kind":"Course","title":"2020 Virtual Conference Private Use - page 603","link":"https://radiopaedia.org/courses/2020-virtual-conference-private-use/pages/603"},{"id":682,"kind":"Course","title":"2020 Virtual Conference Private Use - page 682","link":"https://radiopaedia.org/courses/2020-virtual-conference-private-use/pages/682"},{"id":857,"kind":"Course","title":"2021 Virtual Conference Private Use - page 857","link":"https://radiopaedia.org/courses/2021-virtual-conference-private-use/pages/857"},{"id":857,"kind":"Course","title":"CT \u0026 MRI Lectures - page 857","link":"https://radiopaedia.org/courses/ct-mri-lectures/pages/857"}],"stem":"\u003cp\u003eA 50-year-old man with two days of right lower quadrant pain, nausea, and vomiting, presents to the emergency department. He is diagnosed with acute appendicitis on CT (yellow oval). What is the best interpretation of the red arrow?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1588"}],"attemptsPercentages":[{"alternativeId":"7913","percentage":8},{"alternativeId":"7912","percentage":22},{"alternativeId":"7911","percentage":5},{"alternativeId":"7910","percentage":61},{"alternativeId":"7909","percentage":5}],"promptToLogin":false,"questionManager":false,"articleId":"acute-appendicitis"}