Acute appendicitis

Case contributed by Ioannis Tsamis
Diagnosis certain

Presentation

Epigastric pain from a few hours, which relocated on the RLQ of the abdomen. Positive McBurney sign. Patient with known Autosomal Dominant Polycystic Kidney Disease (ADPKD).

Patient Data

Age: 50 years
Gender: Male
ultrasound

Aperistaltic tubular blind-ending structure on RLQ, non-compressible, consistent with appendix. Dilated appendix 9 mm in diameter, with signs of slight hyperemia (Power Doppler study).

Small hypoechoic area surrounding the tip of the appendix, indicating fluid. 

Tenderness on ultrasound probe palpation, more prominent when corresponded with the dilated appendix. 

Additional findings are multiple large cysts on both kidneys and small ones on the liver parenchyma, as of autosomal dominant polycystic disease

Case Discussion

The findings were consistent with acute appendicitis

The patient went on an-open-surgery appendectomy directly afterwards, which confirmed the diagnosis of acute appendicitis. 

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