Perera Molligoda Arachchige AS, Teixeira de Castro Gonçalves Ortega AC, Amorim Moreira Alves G. Imaging of appendicitis: Computed tomography, magnetic resonance imaging, and ultrasound in diagnosis and management. World J Gastrointest Pathophysiol 2025; 16(4): 112695 [PMID: 41479859 DOI: 10.4291/wjgp.v16.i4.112695]
Corresponding Author of This Article
Gabriel Amorim Moreira Alves, BSc, Faculty of Medicine, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele 20072, Milan, Italy. gabriel.alves@st.hunimed.eu
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 22, 2025 (publication date) through Jan 12, 2026
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Publication Name
World Journal of Gastrointestinal Pathophysiology
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2150-5330
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Perera Molligoda Arachchige AS, Teixeira de Castro Gonçalves Ortega AC, Amorim Moreira Alves G. Imaging of appendicitis: Computed tomography, magnetic resonance imaging, and ultrasound in diagnosis and management. World J Gastrointest Pathophysiol 2025; 16(4): 112695 [PMID: 41479859 DOI: 10.4291/wjgp.v16.i4.112695]
World J Gastrointest Pathophysiol. Dec 22, 2025; 16(4): 112695 Published online Dec 22, 2025. doi: 10.4291/wjgp.v16.i4.112695
Imaging of appendicitis: Computed tomography, magnetic resonance imaging, and ultrasound in diagnosis and management
Arosh S Perera Molligoda Arachchige, Ana Claudia Teixeira de Castro Gonçalves Ortega, Gabriel Amorim Moreira Alves
Arosh S Perera Molligoda Arachchige, Emergency Service, GHOL-Hopital de Nyon, Nyon 1260, Vaud, Switzerland
Ana Claudia Teixeira de Castro Gonçalves Ortega, Gabriel Amorim Moreira Alves, Faculty of Medicine, Humanitas University, Pieve Emanuele 20072, Milan, Italy
Author contributions: Perera Molligoda Arachchige AS conceptualized the study, performed the literature review, and drafted the initial manuscript; Teixeira de Castro Gonçalves Ortega AC contributed to literature review, data interpretation, and critical manuscript revisions; Amorim Moreira Alves G supervised the overall project, provided methodological input, and contributed to editing and final approval of the manuscript; and all authors reviewed the manuscript for intellectual content, approved the final version, and agree to be accountable for all aspects of the work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gabriel Amorim Moreira Alves, BSc, Faculty of Medicine, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele 20072, Milan, Italy. gabriel.alves@st.hunimed.eu
Received: August 4, 2025 Revised: August 18, 2025 Accepted: December 1, 2025 Published online: December 22, 2025 Processing time: 141 Days and 10.7 Hours
Abstract
Acute appendicitis remains one of the most common causes of emergency abdominal surgery globally. Imaging plays a pivotal role in confirming or excluding the diagnosis and identifying complications that influence management pathways. This narrative review synthesizes contemporary evidence and consensus-based imaging protocols for appendicitis, with a focus on computed tomography, magnetic resonance imaging, and ultrasound. The article explores advanced diagnostic criteria, interpretation challenges, imaging algorithms derived from professional society guidelines, and special considerations including pregnancy and pediatric populations. Clinical practice recommendations by the World Society of Emergency Surgery, European Association of Endoscopic Surgery, American College of Radiology, and Infectious Diseases Society of America are incorporated to frame best practices.
Core Tip: Imaging is essential in the accurate diagnosis and management of acute appendicitis, with computed tomography as the gold standard in adults, ultrasound preferred in children and pregnant patients, and magnetic resonance imaging increasingly used to reduce radiation exposure. This article integrates evidence-based imaging protocols and professional society guidelines to guide optimal imaging strategies across various clinical scenarios.
