Presentation
Three days of progressive right lower inferior quadrant pain and fevers. Previous history of bariatric surgery.
Patient Data
Age: 40
Gender: Female
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The appendix is identified partially enlarged ( > 6mm diameter) and associated with periappendiceal inflammation, including stranding of the adjacent fat and thickening of the lateroconal fascia, extraluminal fluid, a distal appendicolith and extraluminal gas inferring its rupture. A fatty liver and expected post-operative changes are also observed in the superior abdomen.
From the case:
Perforated appendicitis
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Yellow arrow: extraluminal gas; Blue arrow: appendicolith; red asterisk: stranding of the adjacent fat.
Case Discussion
This case depicts a complicated appendicitis: perforation occurs in up to 13-30% of cases.
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