Ultrasound of a hyperemic appendix with a thickened wall

Acute appendicitis: 17-year-old female with right lower quadrant pain. Sagittal power Doppler ultrasound (US) image of the appendix (A) shows a markedly hyperemic appendix. Transverse US image of the appendix (B) shows a fluid-filled, appendix with thickened wall (4 mm, arrow). Note echogenic, surrounding fat consistent with peri-appendiceal inflammation.