One day abdominal pain with fever and nausea.
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The appendix is thick-walled with enhancing walls and surrounding inflammatory change. Remainder of the bowel is unremarkable. No free fluid or free gas. No collection.
Liver, spleen, adrenal glands, kidneys, pancreas and gallbladder are unremarkable. No enlarged lymph nodes. Lung bases are clear. No suspicious bone lesion.
CLINICAL NOTES: Appendicectomy
MACROSCOPIC DESCRIPTION: "Appendix": The specimen is an appendix 75mm long and 10mm in
diameter. Parts of the appendix serosa appears slightly congested. An obvious perforation is not seen. LS tip, base. TS through body. (SD)
MICROSCOPIC DESCRIPTION: The sections of appendix show focal mucosal ulceration with an acute inflammatory exudate extending into the lumen. There is partial thickness infiltration of the appendix wall by acute inflammatory cells with associated haemorrhage. No evidence of necrosis is seen. There is no evidence of tumour. The features are of acute suppurative appendicitis.
DIAGNOSIS: Acute suppurative appendicitis.
This case shows classical CT signs of appendicitis - thickened and enhancing walls with surrounding inflammatory change.