Overview of the ultrasonography techniques in the diagnosis of appendicitis – elaboration of a novel anatomy scanning method

This article aims to introduce a novel anatomical scanning method which requires scanning according to varied anatomic positions of the appendix based on the widely used graded compression method. We suggest placing the probe longitudinally in the region of the terminal cecum and moving it laterally to explore the sub-cecal appendix. The probe should be placed transversely on the medial side of the cecum to explore the pre-ileal appendix or post-ileal appendix. Placing the probe perpendicularly along external iliac vessels can help explore the pelvic appendix. The probe should be placed transversely on the paracolic sulci, and moved along the paracolic sulci to observe the extra-peritoneal appendix. Using the cephalic end of the probe as a pivot, push and squeeze the cecum to make it move bilaterally as much as possible, in order to expose the retrocecal appendix behind the air-filled cecum. It is our belief that this anatomical scanning method will greatly improve appendix detection rate and diagnostic accuracy, and provide guidance for surgical localization.