Appendicitis with localised perforation and abscess formation

Case contributed by Dr Matthew Lukies

Presentation

Four day history of right lower quadrant abdominal pain and minimal bowel movements.

Patient Data

Age: 85
Gender: Male

Main findings:

  • thick walled blind-ending vermiform structure arising from the cecum inferior to the ileocecal valve, measuring up to 13 mm in diameter
  • fat stranding around the vermiform structure and an adjacent rounded fluid density without gas locules

These findings are consistent with appendicitis with localised perforation and collection.

Other incidental findings on this CT are:

  • surgical clips in the right inguinal canal consistent with past history of hernia repair
  • uncomplicated sigmoid colonic diverticulae
  • small focal pouch aneurysm of the abdominal aorta just distal to the IMA origin
  • bilateral L5 pars defects and grade 1 L5, S1 anterolisthesis (longstanding)
  • right renal cortical cyst

Case Discussion

The patient in this case proceeded to laparoscopic surgery where an abscess was drained and the appendix removed. Histopathology confirmed the diagnosis of appendicitis.

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Case information

rID: 49035
Case created: 6th Nov 2016
Last edited: 6th Nov 2016
Inclusion in quiz mode: Included

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