The ultrasound image shows a blind-ending, non-compressible, tubular structure in the right lower quadrant with a target or bullseye appearance in transverse section — highly suggestive of the appendix.
Sonographic features of the appendix (especially in suspected appendicitis):
Blind-ending tubular structure arising from the cecum
Non-compressible on graded compression
Diameter >6 mm is suggestive of appendicitis
May demonstrate a “target sign” in transverse view (concentric ring-like appearance)
Increased echogenicity of surrounding fat in cases of inflammation
May contain an appendicolith or show hyperemia on color Doppler if inflamed
The location (right lower quadrant) and appearance in this case are classic for the normal or potentially inflamed appendix.
Differentiation from other options:
A. Fallopian tube: Located more in the adnexal regions and usually not visible unless distended (e.g., hydrosalpinx).
B. Ureter: Usually not visualized on ultrasound unless dilated due to obstruction.
D. Jejunum: Has valvulae conniventes ("keyboard sign") and peristalsis; does not present with a blind-ending tubular appearance from the cecum.
[References:, Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018. Chapter: Gastrointestinal Tract, pp. 460–468., American College of Radiology (ACR). ACR Appropriateness Criteria® — Right Lower Quadrant Pain – Suspected Appendicitis., AIUM Practice Parameter for the Performance of a Pediatric Abdominal and/or Retroperitoneal Ultrasound Examination, 2020., , ]
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