Medical Imaging Department, hôpital Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier cedex 5, France.
Diagn Interv Imaging. 2012 Jun;93(6):441-52. doi: 10.1016/j.diii.2012.04.026. Epub 2012 Jun 1.
Febrile pain in the right iliac fossa is one of the most common reasons for consulting at an emergency service. Within this framework, the main diagnosis that is considered is appendicitis, the main complication of which is perforation. However, a certain number of other conditions can be responsible for this clinical picture, primarily including digestive tract and mesentery disorders including mesenteric lymphadenitis, Crohn's disease, infectious enterocolitis, small intestine or colonic diverticulitis, ischaemic colitis or cancer of the caecum. This article illustrates the imaging semiology of the various right colonic, iliac, mesenteric and appendicular conditions that could potentially cause an infection of the right iliac fossa. It specifies the indications of ultrasound and CT scans, respectively, which depend on the age of the patient and the clinical signs and symptoms. Though the CT scan is commonly used in abdominal emergencies in general, and particularly in clinical pictures of infection of the right iliac fossa, ultrasound remains recommended as first line imaging when confronted with suspected appendicitis or lymphadenitis in a young subject or in the monitoring of Crohn's disease.
右髂窝发热性疼痛是到急诊就诊最常见的原因之一。在此背景下，主要考虑的诊断是阑尾炎，其主要并发症是穿孔。然而，一些其他疾病也可能导致这种临床表现，主要包括消化道和肠系膜疾病，包括肠系膜淋巴结炎、克罗恩病、感染性肠炎、小肠或结肠憩室炎、缺血性结肠炎或盲肠癌。本文阐述了可能导致右髂窝感染的各种右结肠、髂骨、肠系膜和阑尾疾病的影像学表现。它分别说明了超声和 CT 扫描的适应证，这取决于患者的年龄以及临床症状和体征。虽然 CT 扫描通常用于一般腹部急症，特别是在右髂窝感染的临床图片中，但在遇到年轻患者疑似阑尾炎或淋巴结炎或监测克罗恩病时，超声仍被推荐作为一线影像学检查。
