Plain film radiographic diagnosis of acute appendicitis: an evaluation of the signs.

The preoperative plain abdominal radiographs of 34 patients who had had appendectomies were evaluated to determine the frequency of well-known radiographic signs in acute appendicitis. Scoliosis occurred in 17 patients (50%), right lower quadrant (RLQ) fluid levels in 21 (62%), ileus in 24 (70%), and combined RLQ fluid levels and ileus in 27 (80%). Bowel wall edema was seen in eight patients (23%) and calcified coproliths in six (17%). The presence of RLQ fluid levels or localized ileus or both proved to be the most reliable of the signs.