Subhepatic appendicitis complicated with abscess

Case contributed by Dalia Ibrahim
Diagnosis certain

Presentation

Severe right hypochondrial pain

Patient Data

Age: Adult
Gender: Male

The appendix is retro-cecal sub-hepatic in location. It shows mural thickening and enhancement, its lumen is seen distended by fluid density; Extensive blurring and smudging of the surrounding fat planes. Fairly defined elliptical cystic fluid collection is seen at the sub-hepatic and right para-colic region measuring 6 x 3.1 cm along its maximum axial dimensions showing thick enhancing walls and abutting the inferior lateral surface of the liver likely representing an "abscess".

Mild right pleural effusion with bilateral basal atelectatic changes.

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