Appendicitis with microperforation: promontoric type

Case contributed by Dr David Preston


37 year old female presented to ED with generalized abdominal pain, fevers and anorexia.

Patient Data

Age: 37
Gender: Female

Plain abdominal radiographs showed no specific diagnosis.

The appendix is dilated measuring up to 1.2 cm in diameter. There are extensive inflammatory changes surrounding the appendix with a visualized appendicolith. There is tiny locule of extraluminal gas seen adjacent to the inflamed appendix. Findings are in keeping with acute appendicitis with microperforation.

There is free fluid in the pelvis. There is no intra-abdominal or pelvic collection demonstrated. There are secondary inflammatory changes involving the loops of small bowel adjacent to the inflamed appendix.

Case Discussion

The appendix is directed medially along the sacral promontory and classified as promontoric type appendix.

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Case information

rID: 27268
Published: 26th Jan 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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