Presentation
Acute abdomen with right iliac fossa pain of 2 days duration, fever (38 ºC) and single episode of diarrhoea.
Patient Data
Thick-walled markedly enlarged appendix with heterogeneous content. Increased wall vascularity on colour Doppler examination.
An adjacent small amount of turbid fluid is seen.
Inflamed appendix with gangrenous areas and focal perforation.
Case Discussion
Acute appendicitis is the commonest cause of acute abdomen. The patient typically presents with shifting abdominal pain, which usually starts around the umbilicus and shifts gradually to the right iliac fossa. The patient may also present with fever and diarrhoea.
Typical ultrasound findings are an enlarged appendix (more than 6 mm in its outer maximum diameter), thickened/oedematous wall, heterogeneous echogenicity contents, calcified appendicolith, increased wall vascularity, adjacent inflamed omental fat and the presence of free fluid.