Case contributed by Dr Jeremy Jones


HIV positive patient with acute right iliac fossa pain. Clinically, the surgical team were concerned about appendicitis: markedly raised inflammatory markers and guarding.

Patient Data

Age: 40 years
Gender: Male

The CT demonstrates a dilated gas-filled blind-ending viscus within the right iliac fossa. Assocaited inflammation, confirms appendicitis. Addition fatty lump at the neck of the appendix.

Case Discussion

An unusual case of appendicitis.  The surgical team were suspicious clinically and the CT confirms appendicitis.  However, it is unusual to have such a large amount of gas in an inflammed appendix.  In fact, one of the ultrasound features that would sway you away from the diagnosis would be gas within the viscus.

Moreover, the fatty lump at the neck of the appendix is unusual.

Appendicitis was confirmed at pathological examination.

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