Acute appendicitis and COVID 19 pneumonia

Case contributed by Ahmed Samir
Diagnosis certain

Presentation

Fever and right iliac fossa pain

Patient Data

Age: 40 years
Gender: Male
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Axial lung
window
This study is a stack
Sagittal
lung window
This study is a stack
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Info

The appendix is enlarged measuring about 12 mm with thickened wall and increased post-contrast enhancement associated with mild stranding of periappendiceal fat.

Incidentally noted circumaortic left renal vein.

Bilateral multifocal peripheral ill-defined ground-glass opacities with basal and posterior predominance, associated with few subpleural atelectatic bands.

Case Discussion

The patient presented with right iliac fossa pain and fever, no respiratory manifestations, so the clinical diagnosis was acute appendicitis. Routine chest X-ray was suspicious of COVID 19 pneumonia. Therefore, CT chest, abdomen and pelvis was done and revealed acute appendicitis and typical CT features of COVID 19 pneumonia. The first nasopharyngeal swab came negative; however, the second one was positive.

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