Perforated acute appendicitis with abscess formation

Case contributed by Dr Ammar Haouimi

Presentation

Two weeks history of periumbilical and pelvic pain with fever. The ultrasound exam was inconclusive.

Patient Data

Age: 20 years
Gender: Male

Enlarged fluid-filled appendix with thickened enhancing wall, containing an appendicolith. It has a pelvic location with an ascending course of the distal segment, the tip is visible anterior to the IVC bifurcation. Periappendiceal and mesenteric inflammatory changes with adjacent reactive enlarged lymph nodes are noted.

Multiple abscess formations are seen in the pelvic region, extending to the left anterior pelvic wall with signs of pelvic peritonitis. Free peritoneal gas locules are also seen. 

Case Discussion

Ultrasound remains the initial investigation of choice for any suspicion of acute appendicitis in young patients in many centers. CT is highly sensitive and specific for the diagnosis. 

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Case information

rID: 62698
Published: 30th Aug 2018
Last edited: 4th Sep 2018
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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