Presentation
Abdominal pain, fever, cough.
Patient Data
The appendix is dilated with a thickened and enhancing wall. Appendicolith seen at its body. Associated with extraluminal air and surrounding fat streakiness. Multiloculated peripheral rim enhancing collection with multiple air pockets seen at right iliac fossa extending to right anterior and posterior pararenal as well as perirenal regions.
Case Discussion
Features are suggestive of perforated appendicitis complicated with a right-sided intra-abdominal collection.
Concomitant partially treated right lower lobe pneumonia is masking the symptoms of acute abdomen. Hence, the patient has delayed admission to the hospital.
The patient was treated with intravenous antibiotics. Laparoscopic appendectomy was performed. Abdominal drainage was inserted, with its tip at the right paracolic gutter during the operation. The total pus drained within 5 days was 540 ml.
So far, the patient has recovered well after the operation and has been discharged.
Histopathological analysis shows acute suppurative appendicitis with perforation.
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