Acute appendicitis

Case contributed by Dr Sameh Saied Ali


Acute abdomen with right iliac fossa pain of 2 days duration, fever (38 ºC) and single episode of diarrhea.

Patient Data

Age: 25 years
Gender: Male

Thick-walled markedly enlarged appendix with heterogeneous content. Increased wall vascularity on color 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 diarrhea.

Typical ultrasound findings are an enlarged appendix (more than 6 mm in its outer maximum diameter), thickened/edematous wall, heterogeneous echogenicity contents, calcified appendicolith, increased wall vascularity, adjacent inflamed omental fat and the presence of free fluid.

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Case information

rID: 53100
Published: 23rd Dec 2018
Last edited: 6th Nov 2019
Inclusion in quiz mode: Included

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