Ultrasonography-triggered diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis with an atypical symptom pattern: a case report

Hagen Frickmann; Sven A. Jungblut

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Ultrasonography-triggered diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis with an atypical symptom pattern: a case report

CASE REPORT | Updated：2026-03-12

- Ultrasonography-triggered diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis with an atypical symptom pattern: a case report
- Military Medical Research Vol. 3, Issue 3, Pages: 168-172(2016)
- Affiliations：
  
  1.Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Hamburg, Germany
  2.Institute for Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
  3.Practice Dr. Jungblut, Frankfurt/Main, Germany
- Author bio：
  
  *: frickmann@bni-hamburg.de
- Funds：
- DOI：
  CLC：
- Published：2016-09
- Accepted：
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Hagen Frickmann, Sven A. Jungblut. Ultrasonography-triggered diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis with an atypical symptom pattern: a case report[J]. Military Medical Research, 2016, 3(3): 168-172.
DOI：

Hagen Frickmann, Sven A. Jungblut. Ultrasonography-triggered diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis with an atypical symptom pattern: a case report[J]. Military Medical Research, 2016, 3(3): 168-172. DOI：

摘要

Abstract

Background:

Asymptomatic and oligosymptomatic appendicitis are rare and challenging diagnoses that should not be missed.

Case presentation:

A young female patient presented with mild to moderate pain in the middle and lower abdomen

and the results of physical examination

including digital rectal examination

were otherwise non-contributory. Ultrasonography demonstrated a marked increase of the outer appendiceal diameter up to 12.0mm and a trace of free liquid around the terminal ileum. Subsequent surgical exploration and histological examination allowed for a final diagnosis of putrid

ulcero-phlegmonous

hemorrhagic appendicitis and periappendicitis.

Conclusion:

Ultrasonography is increasingly used for the diagnosis of appendiceal inflammation

particularly in military medical settings. Increases in the outer appendiceal diameter up to >6.0mm under compression have recently been demonstrated to be indicative of acute appendicitis. At a minimum

in cases with doubtful physical examination results

ultrasonography should be considered as an element in the diagnosis of acute appendicitis.

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Keywords

references

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