Presentation
Lower abdominal pain.
Patient Data
The appendix measures 15 mm in diameter with moderate surrounding fat stranding and prominent regional lymph nodes. No rim enhancing collection. No localized or free peritoneal gas. No peritoneal free fluid.
The liver, spleen, pancreas, adrenals, kidneys, stomach, small bowel and colon are unremarkable. Lung bases are clear. No suspicious osseous lesions.
Conclusion:
Findings are compatible with acute appendicitis. No evidence of complications arising from this.
Case Discussion
Typical appearances of acute appendicitis. The patient went on to have a laparoscopic appendectomy.
Histology
MACROSCOPIC DESCRIPTION: "Appendix": An appendix 90x12mm with attached mesoappendix up to 9mm thick. The serosa is covered in a fibropurulent exudate, the appendiceal wall is up to 3mm thick and the mucosa is friable.
MICROSCOPIC DESCRIPTION: Sections show appendix which has acute inflammation extending through the appendiceal wall with focal areas of necrosis. No evidence of malignancy is seen.
DIAGNOSIS: Appendix: Acute gangrenous appendicitis.
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