Case contributed by Jack Ren


Right sided abdominal pain with significant tenderness at the right lower quadrant and right lumbar area.

Patient Data

Age: 45 years
Gender: Male

The appendix is abnormally distended to 10 mm and demonstrates mural thickening with surrounding stranding in keeping with acute appendicitis.

Prominent regional ileocolic lymph nodes are identified, measuring up to 9 x 7 mm.

With the exception of the mild stranding around the appendix, there is no free intraperitoneal fluid. No pneumoperitoneum.

No discrete collection.

In segment IV of the liver, there is a 16 x 10 mm low density lesion above the level of the falciform ligament. This probably represents an area of focal fatty change but could be further assessed with an ultrasound.

Otherwise the liver, spleen, adrenals, kidneys and pancreas are normal.

The lung bases are clear.


Acute appendicitis.

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Case information

rID: 30389
Published: 25th Nov 2014
Last edited: 5th Oct 2016
Inclusion in quiz mode: Included

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