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Acute appendicitis

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

RIF abdominal pain for three days.

Patient Data

Age: 45 years
Gender: Female
ct

Moderate fat stranding surrounds the dilated (15 mm) fluid filled appendix arising from the lateral aspect of the caecal 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 subcentimetre 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 ileocaecal valve, arising from the posteromedial aspect of the caecum (90%)
    • tip of the caecum (10%)

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