Acute appendicitis

Case contributed by Assoc Prof Frank Gaillard

Presentation

Abdominal pain.

Patient Data

Age: 25 years
Gender: Male
CT

The appendix, located near the midline, is thickened / edematous, measuring  10 mm in maximal diameter.  Adjacent peri appendiceal fat stranding as well  is moderate volume of free intra-abdominal fluid is demonstrated. No  drainable collection. Oral contrast passes through to the transverse colon, no evidence of bowel obstruction. No free gas. 

The liver, spleen, pancreas, kidneys and adrenals are within normal limits. Several small reactive mesenteric lymph nodes are demonstrated. Dependent atelectasis in the lung bases and small bilateral pleural  effusions.  The bones are within normal limits.

Case Discussion

Patient went on to surgery. 

Histology

MACROSCOPIC DESCRIPTION:

A congested hemorrhagic appendix measuring 60x10mm. There is no perforation identified. 

MICROSCOPIC DESCRIPTION:

Sections show appendix which has a ulcerated mucosal surface with acute inflammation extending through the appendiceal wall with a fibrinopurulent exudate on the serosal surface.  No evidence of malignancy is seen.

DIAGNOSIS:

Appendix:  Acute appendicitis.

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