Appendicular abscess

Case contributed by Dr Abdulmajid Bawazeer

Presentation

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

Patient Data

Age: 35 years
Gender: Female
Ultrasound

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

CT

The appendix is dilated measuring 1.6cm 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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Case information

rID: 59017
Published: 18th Mar 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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