Perforated acute appendicitis

Case contributed by David Puyó
Diagnosis certain

Presentation

Abdominal pain in right iliac fossa, leucocytosis

Patient Data

Age: 40 years
Gender: Female

Caecal appendix with intrapelvic course, increased in diameter up to 15 mm, with diffuse mural thickening, enhancement and endoluminal appendicolith.

Adjacent periappendicular and pelvic inflammatory changes, with some gas bubbles (indicating perforation). Small volume of pelvic free fluid with peritoneal enhancement but no organised collection.

Case Discussion

The findings are consistent with perforated acute appendicitis.

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