Abstract
Three hundred and ninety patients with an equivocal clinical diagnosis of acute appendicitis were evaluated using graded compression sonography. In 9 of 28 patients with visualised normal appendices (based on a maximal outer diameter criterion 6 mm or less) and in 11 of 23 false-positive cases sonography revealed a striking pattern consisting of a relatively homogeneous non-shadowing thick ( > 1.5 mm) central hyperechoic zone coupled with normal wall thickness (< 3.0 mm). Postappendectomy histological correlations obtained in 2 cases from the former group and in 3 cases from the latter one revealed only the presence of chronic coprostasis with no signs of acute inflammation. It is suggested that the appendiceal part displaying the “rod” sign is indicative of dilated faeces-filled lumen (the faecal contents being in some degree inspissated, however, not yet appendicoliths) and it may be classified as normal even if its outer diameter is greater than 6 mm.
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