Presentation
Right lower quadrant pain.
Patient Data
Edematous, hyperemic, noncompressible retrocecal appendix measuring 9 mm in maximum diameter. Hyperechoic periappendiceal fat.
The apex of the cecum is edematous as well, most probably reactive.
Case Discussion
Complained of epigastric pain that had started one day prior and had wandered to the right lower abdomen. Nausea, one episode of vomiting. No fever, diarrhea, or dysuria.
The patient promptly went on to have a laparoscopic appendectomy.
From the surgical report:
Inflamed, phlegmonous retrocecal appendix, covered in fibrin.
Small amount of turbid fluid found in the pelvis.
Histopathology report:
Macroscopic description: 8 cm-long appendix measuring up to 1 cm in diameter. The serosa is gray with hematomas. Closed at its proximal end by a row of staples.
Microscopic description: acute necrotizing appendicitis with periappendicitis.