Fever, nausea and vomiting. Diffuse abdominal pain.
CT Abdomen and pelvis
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The appendix s diffusely enlarged (measuring 2,0 cm in diameter), with thickened walls, and surrounded by periappendiceal inflammation, including stranding of the adjacent fat and minimal extraluminal fluid. Two small calcifications within the appendix base may correspond to appendicolith. There is also a diffuse hepatic steatosis. Remainder exam is unremarkable.
This case shows an exuberant acute appendicitis case in which almost all the radiological signs are present and clearly identified. In older patients like this one, who has abundant intra-abdominal fat in between the bowels, the appendicitis diagnosis is not any challenge. Early presentation in skinny patients, teenagers or even kids can add some difficulty in spotting an inflammated appendix.