Pelvic collections after appendectomy

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Perforated acute appendicitis followed by appendectomy 7 days earlier. Now has global tenderness and raised inflammatory markers.

Patient Data

Age: 35 years
Gender: Female

CT abdomen and pelvis

ct

Posteromedial and inferior to the appendectomy clips, there is a 50 mm fluid density collection with enhancing margins. Posterior to the uterine cervix, there is a 30 mm collection.

Case Discussion

Collections identified a few days after bowel surgery may be due to leaks from anastomoses, evolution of hematomas, or from undrained pockets of infected fluid which have matured.

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