Presentation
Right iliac fossa pain, accompanied by nausea.
Patient Data
There is a 4 x 5 x 7 cm isodense inflammatory mass extending medially from the medial aspect of the cecum, not liquefied, and showing mild heterogeneous contrast enhancement. There is moderate inflammatory stranding in the surrounding fat, which extends along the feeder mesenteric vessels. The appendix is not identified, and there is no appendicolith in the appendiceal bed. Multiple enlarged regional mesenteric adenopathy is noted.
Incidentally noted collapsed gallbladder with gallstones (cholelithiasis) and a cystic lesion measuring 5 x 8 x 5 cm in the right adnexa in the pelvic region (ovarian cyst).
Case Discussion
Complicated appendicitis can be defined as either perforated, peri-appendicular abscess, peritonitis, or a combination of either, which is essentially an acute inflammation of the peritoneum secondary to infection of appendix 1. Complicated appendicitis can be distinguished from uncomplicated appendicitis in that the latter consists of an inflamed appendix on its own without any secondary features, e.g. appendix perforation, appendicolith, etc. 2.
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