Presentation
RIF abdominal pain for three days.
Patient Data
Moderate fat stranding surrounds the dilated (15 mm) fluid filled appendix arising from the lateral aspect of the cecal pole and extending inferiorly and anteriorly, measuring approximately 7 cm in total length. No collection or evidence of perforation identified. No free fluid or pneumoperitoneum. The remainder of the bowel and solid organs appear normal. Multiple prominent subcentimeter mesenteric and retroperitoneal lymph nodes.
Conclusion
Appendicitis without evidence of perforation. The multiple enlarged draining lymph nodes are probably reactive.
Case Discussion
Key learning points:
- appendix is typically located
- inferior to the ileocecal valve, arising from the posteromedial aspect of the cecum (90%)
- tip of the cecum (10%)