CT Abdomen and pelvis
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A large, dilated, rim-enhancing fluid-filled structure with gas locules and an air-fluid level is present in the right iliac fossa contiguous with the caecum and separate from the ileocaecal valve. It has a tubular configuration with a more tubular projection medially from it. There is curvilinear mural calcification within the wall inferiorly.
There is marked surrounding inflammatory fat stranding.No definite free intra-abdominal gas or fluid identified. No diverticular disease.
Gallbladder with a large mixed density gallstone is demonstrated. No pericholecystic fluid or fat stranding to suggest acute cholecystitis.
Fatty pancreatic atrophy (mainly involving the pancreatic head) noted. Tiny renal cysts and contrast in the renal collecting systems noted. Mildly fatty infiltration of the liver.
The remainder of the solid and hollow abdominal viscera are within normal limits for age.
Vaginal ring pessary in-situ projecting into the posterior vaginal fornix.
Minor bibasal atelectasis noted. No destructive bony lesions.
Conclusion: Findings are most in keeping with a large inflamed/super-infected appendiceal mucocele. No definite evidence of perforation. Cholelithiasis.