盲腸（C）は図６で盲端になり，回腸末端（TI）は図１から始まる．図６の１が虫垂根部で，数字順に進展し図７の１２で盲端になる．１〜５は虚脱しており，６の糞石が閉塞部位を示し，7から拡張し始める．最大径1cm以上に腫大し，壁はよく造影され急性虫垂炎であるが，図１〜図７でかなり広範囲のphlegmon（脂肪組織の蜂巣炎：▲）を呈し，図１２〜図１４では骨盤腔内に相当量の腹水を認める（※）ので穿孔性虫垂炎を疑うべきである．手術で膿性腹水があり，壊死性虫垂炎を認め，先端近くで穿孔していた（図A）．病理：gangrenous appendicitis

文献考察：CTの早期応用によって，虫垂炎の重症度が減少し，入院日数も減った．CT grade（表）
Radiology. 2003 Feb;226(2):521-6.
Acute appendicitis: effect of increased use of CT on selecting patients earlier.
Raptopoulos V, Katsou G, Rosen MP, Siewert B, Goldberg SN, Kruskal JB.
PURPOSE: To explore the possibility of a relationship between increased use of computed tomography (CT) for diagnosis of appendicitis and increased occurrence of minimal or subtle CT and surgical findings. MATERIALS AND METHODS: Two groups, each with 50 consecutive patients who underwent CT before appendectomy in 1997 and 2000, were compared. CT scans and surgery-pathology reports were evaluated on a six-grade scale from normal to abscess or inflammatory mass. The demographics, surgical techniques, hospital stay, and grade distribution for the two groups were compared, and the CT results were correlated with surgical findings. RESULTS: In 1997, CT was performed in 33% (50 of 152) of patients undergoing appendectomy, as compared with 59% (50 of 85) 3 years later (P <.001 there was excellent correlation between surgical-pathologic and ct grades kappa p spearman rank no significant difference in demographics rate of surgery or surgical techniques used but a decrease the median from to for all patients who underwent ct. similarly grade decreased seven had subtle findings compared with mean hospital stay days conclusion: increased use were less severe imaging including absence periappendiceal stranding severity appendiceal disease stay.pmid: text>