Sonography of appendicitis and acute diseases of the lower abdomen.

The high diagnostic ability of sonography for the solid organs of the upper abdomen and the biliary and genitourinary tract is well established. The gut on the other hand has been more or less ignored by many sonographers in routine abdominal screening and evaluation of the acute abdomen. This is regrettable because sonography, like CT, is an excellent modality for assessing mural abnormalities of various origin (i.e. neoplastic, inflammatory, ischemic or hemorrhagic), as well as possible involvement of the adjacent soft tissues and solid organs. Considerable sonographic skill and "tenacity" and an adequate equipment are however indispensable to achieve high diagnostic reliability in the detection and interpretation of abnormalities of the G-I tract. Our own and other's experience suggest that the time devoted to sonographic screening of the gut is very worthwhile especially in acute clinical conditions. Acute appendicitis is one of the typical examples where sonography has found widespread acceptance. This article reviews the application of graded compression sonography in the evaluation of appendicitis, for using on technique, diagnostic criteria, and differential diagnosis.