Large dilated appendicitis

Case contributed by Dr Craig Hacking

Presentation

RIF pain

Patient Data

Age: 30-35 years
Gender: Male
CT

There is a fluid filled dilated (20mm calibre) blind ending structure in the RIF which is probably arising from the caecal pole, rather than the terminal ileum. No calcification or wall thickening / irregular. No surrounding RIF fat stranding or fluid. I favour this to represent an appendiceal mucocoele rather than acute appendicitis.

Solid organs are unremarkable. No free fluid or gas. Lung bases are clear. Bones normal.

Case Discussion

Histology

MACROSCOPIC DESCRIPTION:

"Appendix mucocele": An appendix 40x14x14mm with attached mesoappendix up to 25mm and attached piece of caecum 30x14x13mm. Caecal margin inked black. The mucosa is tan and the serosa is congested. Tumour or mucus is not seen. There is no perforation.

MICROSCOPIC DESCRIPTION:

Sections of appendix and attached large bowel show intact appendiceal mucosa with focal acute inflammation including crypt abscesses and a mild to moderate transmural acute inflammatory cell infiltrate. Perforation is not seen. The lumen is not distended by mucus and there is no dysplasia. There is no evidence of malignancy.

DIAGNOSIS:

Appendix: Acute appendicitis. No evidence of a neoplasm.

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Case information

rID: 42388
Case created: 19th Jan 2016
Last edited: 21st Aug 2017
Inclusion in quiz mode: Included

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