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Appendix CT Scan Normal Vs Appendicitis Images | Acute, Gangrenous Types & Perforated Appendix *Cases Acute Appendicitis - 0:00 Caecal Bar Sign - 3:44 Arrowhead Sign - 4:07 Gangrenous Appendicitis - 7:49 Perforated Appendicitis - 8:57 Normal Appendix: Diameter less than 6mm Normal fat around the appendix appears hypodense (dark) and homogeneous Acute Appendicitis: Dilated fluid-filled appendix (Diameter more than 6mm) Appendicolith: Hyperdense (bright) structure within the appendix The normally homogeneous, low-density fat tissue around the appendix appears more dense (brighter) and heterogeneous. Gangrenous Appendicitis: Parts of the wall may show lack of enhancement after contrast administration More extensive and intense fat stranding Gas formation within the appendix due to gas-producing bacteria involved in the infection. Perforated Appendicitis: Focal appendiceal wall defect Extraluminal gas Periappendiceal inflammation Periappendiceal Phlegmon: Severe inflammation with extensive fluid collection. Usually has higher density (appears brighter) than abscess. Has ill-defined borders Abscess: Has lower density (appears darker) than a phlegmon. Has a clear border or a wall, which may enhance after the administration of contrast material, indicating an inflammatory response.