Perforated appendicitis

Case contributed by Dr Bruno Di Muzio


Three days of progressive right lower inferior quadrant pain and fevers. Previous history of bariatric surgery.

Patient Data

Age: 40
Gender: Female

CT Abdomen and pelvis

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. 

Annotated image

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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Case information

rID: 39799
Published: 21st Sep 2015
Last edited: 21st Sep 2015
Inclusion in quiz mode: Included

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