The prevalence and patterns of intraluminal air in acute appendicitis at CT

Miguel Cabarrus, Yee Li Sun, Jesse L. Courtier, Joseph W. Stengel, Fergus V. Coakley, Emily M. Webb

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


The purpose of this study is to investigate if the presence and distribution of intraluminal air in the appendix contributes to the computed tomography (CT) diagnosis of appendicitis. We identified 100 consecutive patients (57 men and 43 women; mean age, 38) with CT prior to appendectomy for acute appendicitis over a 5-year period and a control group of 100 consecutive patients (29 men and 71 women; mean age, 39) who underwent CT for acute abdominal pain without appendicitis. Patients were scanned using multidetector row CT scanners at 1.25 or 5-mm slice thickness, peak tube voltage of 120 kVp, and milliamperse automatically adjusted to attain a noise index of 12. Ninety-two of 100 study patients and 95 of 100 controls received 150 mL intravenous contrast. Two independent readers noted the presence and distribution pattern of intraluminal air in the appendix, appendiceal diameter, wall hyperemia, wall thickening (>3 mm), and wall stratification and presence of any secondary signs of appendicitis including fat stranding and free fluid. Data were compared between groups using Fisher's exact test and Student's t test. Intraluminal air in the appendix was more common in control patients versus patients with appendicitis (66 of 100 versus 27 of 100, p < 0.001). No significant differences in the patterns of intraluminal air were found between cases and controls. Among appendicitis cases, there was no significant difference in mean appendiceal diameter (12.8 versus 12.0, p = 0.20) or number of CT signs of appendicitis (1.93 versus 1.86, p = 0.78) in cases with intraluminal air versus without. No case of appendicitis demonstrated intraluminal air without secondary signs of appendicitis. Although intraluminal air is sometimes assumed to exclude a diagnosis of appendicitis, it is actually a common finding seen in up to 27 % of cases at CT. The pattern of intraluminal air was not helpful in differentiating a normal appendix from appendicitis.

Original languageEnglish (US)
Pages (from-to)51-56
Number of pages6
JournalEmergency Radiology
Issue number1
StatePublished - Jan 2013
Externally publishedYes


  • Acute appendicitis
  • CT
  • Intraluminal air

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging


Dive into the research topics of 'The prevalence and patterns of intraluminal air in acute appendicitis at CT'. Together they form a unique fingerprint.

Cite this