Computed tomography findings of normal appendix in pediatric population

Authors

• Thanwarat Koonthong, Department of Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial HospitalFollow
• Teerasak Phewplung*, *Correspondence to: Teerasak Phewplung, MD, Department of Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand. E-mail: Teerasak.P@chula.ac.thFollow

Abstract

Background: Appendicitis remains the most common indication for emergency abdominal surgery in children. Computed tomography (CT) plays a vital role in the evaluation of pediatric patients with suspected appendicitis. Yet, there is limited of literature describing the normal appendiceal diameter in the pediatric Asian population.

Objectives: To characterize the normal pediatric appendix and to identify the variables that influence its diameter in pediatric patients aged one day to 18 years who underwent abdominal CT.

Materials and Methods: The study was approved by the IRB. We conducted a retrospective study of 358 children (≤18 years of age) who underwent abdominal CT scans between Jan 1, 2018, and Dec 31, 2022, for indications unrelated to appendicitis. Demographic data, including calculated BMI and BSA were recorded. Radiologic data of the appendices included the maximal outer diameter and the single wall thickness. The data was classified into five stratifications based on age. The mean appendiceal diameters were calculated. Associations between appendiceal diameter with age and BSA were applied using a linear regression model.

Results: The mean appendiceal diameter was 5.00 ± 1.09 mm. Stratified analysis by age revealed the following mean appendiceal diameters: 4.22 mm (0-1 years), 4.35 mm (1-5 years), 4.85 mm (5-10 years), 5.54 mm (10-15 years), and 5.83 mm (15-18 years). Age and body BSA demonstrated significant predictive variability for appendiceal diameter (p2).

Conclusions: Uniform diameter cutoffs for appendiceal diameter should not be applied across the pediatric population because the appendix grows during childhood. This study demonstrated a positive correlation between appendiceal diameter and age, as well as appendiceal diameter and BSA.

DOI

10.56808/2673-060X.5559

Recommended Citation

Koonthong, Thanwarat and Phewplung*, Teerasak (2026) "Computed tomography findings of normal appendix in pediatric population," Chulalongkorn Medical Journal: Vol. 70: Iss. 4, Article 2.
DOI: https://doi.org/10.56808/2673-060X.5559
Available at: https://digital.car.chula.ac.th/clmjournal/vol70/iss4/2