Acute appendicitis with appendicolith

Case contributed by Dr Jeremy Jones

Presentation

Abdominal pain and tenderness. Right iliac fossa guarding. Peritonitic. Raised inflammatory markers.

Patient Data

Age: Middle-aged
Gender: Male
Modality: CT

Inflammatory mass localised around an appendicolith in the right iliac fossa. Inflammatory mass breeches the anterior abdominal wall through the spigelian fascia.

Case Discussion

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.

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Case Information

rID: 6062
Case created: 14th Apr 2009
Last edited: 6th Dec 2016
Inclusion in quiz mode: Included

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