Appendicular abscess

Case contributed by Abdulmajid Bawazeer
Diagnosis certain


Over a week of symptoms including right iliac fossa pain, fever, anorexia, nausea and vomiting.

Patient Data

Age: 35 years
Gender: Female

There is an aperistaltic, non-compressible, dilated tubular structure (appendix). Periappendiceal hyper-echoic fat. Well defined large lower abdominal/pelvic collection (surrounding the uterus).


The appendix is dilated measuring 1.6 cm in diameter. It has a thickened, enhanced wall with a distal discontinuity representing the perforation. It is associated with periappendiceal fat stranding and multiple loco-regional enhanced lymph nodes. A large (12 x 10 x 9 cm), well-defined, irregular fluid collection with an enhancing wall is seen.

Case Discussion

Misdiagnosis of appendicitis or delay in seeking medical attention can lead to rupture of an inflamed appendix with abscess formation.

Diagnosis was confirmed via laparoscopic appendectomy with surgical drainage of the abscess.

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