Ultrasound findings of appendicitis

These ultrasound images are taken from a patient with early appendicitis at surgery. They demonstrate important diagnostic findings of acute appendicitis without evidence for perforation or abscess formation:
(A) A dilated tubular fluid-filled structure in the right lower quadrant with a blind-ending tip is identified, consistent with the appendix.
(B) The appendix is dilated, measuring up to 1.2 cm in the transverse dimension.
(C) There is a hyperechoic shadowing focus within the midportion of the appendix, consistent with an appendicolith.
(D) There is increased echogenicity of the periappendiceal fat and hyperemia observed on color Doppler imaging.
On further ultrasound imaging (not shown), there is trace free fluid noted in the right lower quadrant, and no periappendiceal abscess is identified.