Appendicitis with appendicular abscess

Case contributed by Nikhil Narayanan

Presentation

Abdominal pain.

Patient Data

Age: 7 years
Gender: Male
ultrasound

The first image shows thickened appendix with periappendiceal fat stranding and inflammatory changes. The maximum transverse diameter was found to be approximately 7.6 mm (upper limit of normal 6 mm).

There is an associated heterogeneously hypoechoic area noted deep to the region of appendix. No internal vascularity was seen on the color doppler study (third image). Hypoechoic areas with internal septations with could be correlated with long-standing abscess formation (final image). Appearances are consistent with ongoing appendicitis with adjacent abscess formation. 

Case Discussion

Appendicitis is one of the commonest surgical causes of pain in right iliac fossa, especially in children as well as in adults. Perforation with abscess formation is a recognized complication. 

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