Acute appendicitis

Case contributed by Jack Ren

Presentation

Right lower quadrant pain.

Patient Data

Age: 45 years
Gender: Male
CT

The appendix is markedly enlarged, with thick enhancing wall and surrounding stranding. 

The patient went on to have a appendicectomy. 

Histology

MACROSCOPIC DESCRIPTION

An appendix measuring 95 mm in length x 32 mm in diameter at the fundus. There is attached fat surrounding the appendix. The surface of the appendix and adjacent fat is covered in cream coloured exudate. Section of the tip of the appendix reveals a communication between the lumen of the appendix within surronding fat. However no discrete lesion identified. No faecolith within the lumen

MICROSCOPIC DESCRIPTION

The appendix lumen contains pus. There is an intense transmural acute inflammatory cell infiltrate, with a thick fibrinopurulent exudate on the free serosal surface. There is also focal rupture into the mesoappendix with abscess formation. No malignancy is identified

DIAGNOSIS

Appendix - acute suppurative appendicitis with abscess formation confirmed.

Case Discussion

This patient had a strikingly enlarged and thickened appendix, so much so that it looks similar to adjacent small bowel. 

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Case information

rID: 23280
Case created: 2nd Jun 2013
Last edited: 25th Nov 2015
Inclusion in quiz mode: Included

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