Acute appendicitis - early perforation with peritonitis

Case contributed by Michael P. Hartung
Diagnosis almost certain

Presentation

Abdominal pain.

Patient Data

Age: 40 years
Gender: Male

Dilated, fluid-filled appendix which is irregular and discontinuous by the base with some extraluminal gas. Right lower quadrant peritonitis with bowel serosal thickening and submucosal edema and fat stranding. Small ascites. No collections.

Case Discussion

Teaching case illustrating acute appendicitis complicated by perforation at the appendiceal base, with extraluminal locules of air and peritonitis (bowel serosal thickening is the major hint).

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