Presentation
Severe abdominal pain, vomiting, fever and nausea for 2 days.
Patient Data
Small bowel loops dilatation. No pneumoperitoneum. No large bowel loops dilatation.
Erect chest radiograph: no air under diaphragm.
A blind-ending tubular structure seen at the right iliac fossa, measuring 1.6cm in diameter. It represents dilated appendix. Focal discontinuity of the enhancing mucosa at the base of appendix. It is associated with significant amount of periappendiceal fat streakiness.
Case Discussion
CT findings are in keeping with acute appendicitis complicated with perforation.
Intraoperative findings:
-Grossly purulent contamination at right paracolic gutter, pelvis, perihepatic and inter bowel loops
- Perforated appendicitis (perforation at the tip and base, base: unhealthy; oedematous with 1cm perforation)
-Limited right hemicolectomy with double barrel stoma created at RIF
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