Acute appendicitis with appendicolith
Abdominal pain and tenderness. Right iliac fossa guarding. Peritonitic. Raised inflammatory markers.
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Inflammatory mass localised around an appendicolith in the right iliac fossa. Inflammatory mass breeches the anterior abdominal wall through the spigelian fascia.
Appendix mass surrounding an appendicolith is a relatively common finding in the setting of clinical symptoms and signs of appendicitis. The inflammatory mass in this case extends anteriorly to the peritoneal surface and then into the anterior abdominal wall through a defect in the spigelian fascia (confirmed surgically).
This case highlights the importance in reporting the extent of any inflammatory mass to that the surgical team has as much information as possible when they operate.