The patient had a one month long history of lower abdominal pain, and a one day history of bloating. There was no vomiting or nausea. 38.7C temperature was recorded upon admission. Physical exam showed tenderness at the McBurney point. Abdominal ultrasound was not informative, regarding the appendix. Laboratory findings were elevated CRP, ALP, GGT, and WBC.
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The patient had a negative ultrasound scan before the CT.
CT revealed a retrocaecal, distended appendix, with hypodense content. Mild fat stranding was seen in the mesoappendix. No free abdominal air or fluid was detected. There was only one enlarged lymph node in the vicinity of the appendix.
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Appendicitis mainly affects children and young adults, but elderly patients can also be affected. A retrocoecally located appendix, can obscure the sonographic visualization of the organ.