Subhepatic appendicitis

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Pain epigastrium and right hypochondrium for 1 day, associated with anorexia. Also complain of dysuria. No fever, vomiting or change in bowel habits.

Patient Data

Age: 25 years
Gender: Male
ct
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
non-contrast
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
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Info

Enlarged appendix measuring 12 mm in diameter and approximately 9 cm in length with its tip lying in the subhepatic location. It shows intense mucosal enhancement and mild fat stranding and minimal free fluid around the appendix. No radiopaque appendicolith, sizable fluid collection, significant loco-regional lymphadenopathy or pneumoperitoneum is seen. 

Case Discussion

Procedure: Laparoscopic appendectomy.

Gross description: The specimen is received in formalin in one container, labeled as appendix. It consists of an intact appendix measuring 0.5 x 0.6 x 8.0 cm. Outer serosa is intact. Serial sectioning shows necrotic lumen.

Diagnosis: Acute appendicitis.

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