Presentation
Right-sided abdominal pain for the last 3 days. No urinary complaints.
Patient Data
There is an acoustic shadow at the junction of the appendix with cecum. It is an appendicolith measuring about 13 mm. The rest of the appendix is distended with echoes. There is a breach in the gut signature sign of the appendix with adjacent intraperitoneal collection (about 12 cc). There is significant periappendiceal fat inflammation. The cecum as well as terminal ileum show thickened wall.
The kidney tray shows a resected appendix and an appendicolith.
Case Discussion
The case shows acute appendicitis due to an appendicolith at its base. There is appendiceal perforation with a small local collection.
Gross specimen photo courtesy: Operating surgeon Dr. Niraj I. Patel.