Right iliac fossa pain.
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The appendix is distended and thick walled with marked periappendiceal inflammatory change. The tip of the appendix extending cranially into the paracolic gutter.
No free gas, fluid or collection.
No other significant abnormality.
The typical appearances of acute appendicitis.
IV contrast is not the be-all and end-all in imaging the acute abdomen. A good deal of pathologies may be adequately diagnosed without IV contrast when necessary.
This is especially the case in high BMI patient when stranding fat often signals the site of pathology.
Renal impairment is the commonest reason for undertaking a CT abdomen without contrast.