Presentation
Fever and right iliac fossa tenderness for 1 day.
Patient Data
An elongated calcific density is seen in the right iliac fossa measuring 2.3 x 1.2 cm, suggestive of an appendicolith. There is loss of normal anatomical configuration of the appendix showing heterogeneously enhancing thick walls with associated mild interbowel free fluid in the lower abdomen and pelvis. There is moderate periappendiceal fat stranding with specks of air adjacent to the expected location of the appendix. Mild free fluid seen in lower abdomen. Mild wall thickening is seen involving terminal ileum and cecum, likely reactionary due to ongoing inflammation. Multiple prominent mesenteric lymph nodes are seen along the right ileocolic chain. Overall findings are suggestive of complicated/perforated appendicitis.
Case Discussion
Imaging findings of this patient were immediately communicated to the surgical team. She underwent appendectomy and CT findings were confirmed.