Acute appendicitis

Case contributed by Dr Yair Glick

Presentation

Diffuse abdominal pain, nausea, and diarrhea.

Patient Data

Age: 30 years
Gender: Female

US of the RLQ

Ultrasound

Edematous, slightly hyperemic appendix measuring 13 mm in maximal diameter. Periappendiceal fat stranding and minuscule amount of free fluid.

The rest of the abdominal ultrasound examination (not shown) was normal.

Case Discussion

A young, healthy, non-smoker, presented to the HMO with complaints of abdominal pain that began that same morning, nausea without vomiting, and two bouts of diarrhea. Physical exam was notable for epigastric and right lower quadrant tenderness. She was referred to the ER. In the ER, the surgeon could not elicit peritoneal irritation but referred her for abdominal ultrasonography.
Ultrasonography revealed an edematous, grossly dilated, slightly hyperemic vermiform appendix, with a minute amount of clear periappendiceal fluid.
She promptly underwent an uneventful laparoscopic appendectomy, where an inflamed appendix was excised.

Pathology report:
Acute appendicitis with periappendicitis.

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