Presentation
Abdominal pain and low grade fever 12 days duration.
Patient Data
There is a 6.5 cm x 5.7 cm x 8.5 cm circumscribed, oval-shaped thick fluid attenuating collection in the right iliac fossa with internal air foci. The lesion has surrounding soft tissue fat stranding and has post-contrast peripheral/wall and surrounding soft tissue enhancement. The base of the appendix is dilated measuring 21mm with intraluminal appendicolith and fluid content and has communication with the loculated collection representing a large appendicular abscess.
There is also a dilated fluid-filled small bowel segment adjacent to the appendicular abscess representing a focal ileus or sentinel loop sign.
Additionally, the right renal fossa is empty with a midline abdominal ectopic kidney.
Case Discussion
The findings described at the level of right iliac fossa explained by complicated acute appendicitis with appendicular abscess.
Finally, the patient under go for surgical management, Intra operatively appendix is perforated at the tip and about 180 ml thick pus found and drained.
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