BACKGROUND: Although the radiographic characteristics of acute appendicitis have been well documented, the value of plain abdominal radiograph has not been completely studied. Therefore, the purpose of this investigation was to verify a new radiographic sign: the presence of fecal loading in the cecum. METHODS: One hundred seventy consecutive patients of both sexes have been studied prospectively. They were admitted to the hospital due to acute abdominal pain localized in the right flank. The patients were divided in two groups: Group 1 (n = 100) - diagnosed clinically as acute appendicitis and submitted to an abdominal radiographic study a few hours before surgical treatment. Group 2 - (n = 70) -patients submitted to two abdominal radiographic studies, one before the surgical procedure and the other the following day. All of the radiographs were plain with an anteroposterior view of the abdomen. RESULTS: The sign of fecal loading in the cecum was present in 97 (97%) patients of Group 1 and in 68 (97.14 %) patients of Group 2. During the postoperative period the radiographic sign disappeared in 66 of the 68 cases that had this sign. The sensitivity of the radiographic sign for acute appendicitis was 97.05%. CONCLUSION: The radiographic image of fecal loading in the cecum is associated with acute appendicitis. This sign usually disappears after the withdrawn of the appendix.
Appendicitis; Radiography; Cecum; Fecal impaction; Diagnosis
