Presentation
Right iliac fossa pain. Physical examination showed guarding at the right iliac fossa with rebound tenderness.
Patient Data
Dilated fluid filled appendix (5 HU) is seen extending medially and inferiorly measuring around 20 mm in maximal diameter and proximally around 6 mm, without siginificant surrounding fat stranding or fluid collections. The wall of the tip of appendix shows enahncement, but no wall calcification is noted. Findings indicate appendicular mucocele for further evaluation.
Unremarkable liver, spleen, pancreas and both kidneys.
No adrenal masses or retro peritoneal lymphadenopathy.
Normal urinary bladder, seminal vesicles and prostate gland.
No evidence of intra-abdominal or pelvic free air or free fluid.
Fecal loading of the colon and rectum.
Case Discussion
This patient presented through ER, with right iliac fossa pain, and on examination showed rebound tenderness at this area. Abdomen and pelvis CT was requested directly due to repeated episodes of this pain and upon patient's request. This showed a fluid filled dilated appendix without surrounding fat stranding, free fluid or lympadenopathy. After the CT, laproscopy was carried out and confirmed uncomplicated mucocele of the appendix.
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