Complicated sub-hepatic appendicitis

Case contributed by Amr Farouk
Diagnosis certain

Presentation

Right upper quadrant pain

Patient Data

Age: 15 years
Gender: Male
ultrasound

Right peri-hepatic encysted creeping turbid fluid collection with a blind-ended tubular bowel loop (representing the appendix) seen showing calcified lesion within causing posterior acoustic shadowing (appendicolith).

CT exam showed dilated enlarged appendix at a sub-hepatic location with appendicolith within (corresponding to the posterior acoustic shadowing on sonography) associated with surrounding fluid collection, fat smudging and thickening of the related peritoneal reflections.

Case Discussion

US and CT picture suggestive of complicated sub-hepatic appendicitis which was confirmed via laparotomy.

Case courtesy Dr. Wael M.Hassan

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