Presentation
Right upper quadrant pain
Patient Data
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