Presentation
Right lower quadrant pain.
Patient Data
Age: 50 years
Gender: Male
From the case:
Perforated appendicitis
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Perforation of the appendix (with appendicolith) with right lower quadrant peritoneal thickening/stranding, serosal thickening/inflammation with submucosal edema involving adjacent small bowel loops and the cecum, and small extraluminal collection containing mottled air.
Case Discussion
Common findings of perforation of the appendix:
- relatively decompressed appendix with appendicolith (decompression occurs after it perforates)
- subtle mucosal defect near the tip indicating the site of perforation
- right lower quadrant peritonitis resulting in peritoneal thickening, serosal thickening/hyperenhancement, and submucosal edema
- extraluminal collection containing mottled air
Remember to check for complications including thrombophlebitis of the superior mesenteric vein and liver abscess (which are not present).
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