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Ultrasound Report Explanation - Miss Darpan Abhinav (28 Months / Female)
Referring Doctor: Dr. S.K. Singh M.D. (Pediatrics) | Date: 14.07.2026 | Radiologist: Dr. Amaresh Kumar, M.D. (Radio-diagnosis)
What the Report Says - Plain Language Summary
This is a whole abdomen ultrasound of a 28-month-old girl. Here is what each finding means:
Normal Findings (All Organs Clear)
| Organ | Finding | What it Means |
|---|---|---|
| Liver | Normal shape, size, echotexture; IHBR not dilated; Right lobe 9.6 cm | Healthy, no enlargement, no bile duct blockage |
| Gall Bladder | Normal volume, echo-free lumen | No stones, no inflammation |
| Common Bile Duct (CBD) | Normal, echo-free | No blockage |
| Pancreas | Normal; no calcification or mass | No pancreatitis or tumour |
| Spleen | Normal shape, size, echotexture | Healthy |
| Both Kidneys | Normal size and texture; cortico-medullary differentiation intact; no stones; no hydronephrosis | No kidney disease or obstruction |
| Right kidney | 7.1 cm bipolar | Normal for age |
| Left kidney | 7.6 cm bipolar | Normal for age |
| Urinary Bladder | Normal outline, echo-free | No infection or stones |
| Lymph nodes / fluid | No retroperitoneal / mesenteric adenopathy; no ascites | No lymph node swelling; no free fluid in abdomen |
The Key Abnormal Finding
R.I.F. (Right Iliac Fossa) - Appendix:
- Thick (6.4 mm), oedematous (swollen), and irregular in outline
- No appendicular mass or collection (no abscess)
Why 6.4 mm matters: According to standard radiology criteria, an appendix >6 mm in diameter on ultrasound - especially when it is non-compressible, oedematous, and irregular - is a positive sign for appendicitis (Schwartz's Principles of Surgery, 11th Ed.). A normal appendix typically measures <5 mm and compresses easily. In this child, the appendix measures 6.4 mm with visible wall swelling, satisfying the ultrasound criteria for appendicitis (Rosen's Emergency Medicine - diagnostic criteria: appendiceal diameter >6-7 mm + noncompressible appendix).
Opinion: Recurrent Appendicitis
The radiologist's conclusion is "Recurrent Appendicitis" - meaning this child has had repeated or ongoing bouts of appendix inflammation, rather than a single acute episode.
Important clinical points for a 28-month-old with this finding:
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Appendicitis in very young children is rare but dangerous. Children under 3 years have the highest rate of perforation (rupture) because they cannot clearly describe their symptoms, and the diagnosis is often delayed. - Schwartz's Principles of Surgery, 11th Ed.
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"Recurrent appendicitis" (also called chronic or relapsing appendicitis) refers to repeated episodes of inflammation that partially resolve, only to flare again. The standard surgical recommendation is appendectomy (surgical removal) after the acute phase is managed, to prevent future rupture.
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No abscess or collection is reassuring - this means the appendix has not ruptured yet. This is an important finding because it means the current episode is not yet a surgical emergency requiring immediate operation.
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The suggestion to "rescan after a course of treatment" means the radiologist is recommending that the child be treated (likely with antibiotics as prescribed by the pediatrician) and then have a follow-up ultrasound to confirm improvement. However, since this is described as recurrent appendicitis, the treating pediatric surgeon will likely discuss elective appendectomy (planned removal of the appendix) once the child is stabilized.
What the Parents / Family Should Know
- This report does not indicate a ruptured appendix right now - that is good news.
- The child needs to be seen promptly by a pediatric surgeon, not just the pediatrician.
- If the child develops worsening abdominal pain, fever, vomiting, or a rigid/hard abdomen, go to the emergency department immediately as this could indicate perforation.
- Do not delay surgical consultation - in toddlers, the appendix can rupture faster than in older children or adults because the omentum (which walls off infections in adults) is less developed.
- All other organs (liver, kidneys, spleen, gallbladder) are completely normal - this is a localized finding confined to the appendix area.
Note: This explanation is for educational purposes only. It should be reviewed together with the child's clinical symptoms, physical examination findings, and blood tests (CBC, CRP) by the treating pediatrician and/or pediatric surgeon before any treatment decision is made.
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