Presentation
Presents to the ER with exquisite tenderness in the right upper and lower quadrants.
Patient Data
There are marked inflammatory changes in the right lower quadrant. The appendix is dilated, fluid-filled, and there is periappendiceal fat stranding. There is also fat stranding surrounding the cecum and a cecal diverticulum which is hyperdense. Several other non-inflamed diverticuli are seen in the ascending colon.
Case Discussion
There is marked fat stranding in the right lower quadrant. While both the cecum and the appendix appear involved, the inflammation appears centered around a hyperdense cecal diverticulum. This is a surgically proven case of cecal diverticulitis. Changes in the appendix are reactive to the primary process within the cecum. Surgical exploration revealed an inflamed and edematous cecum with intramural abscess. Ileocecectomy was successfully performed.