Presentation
Right lower quadrant pain for the past three days, with local tenderness and guarding on physical exam.
Patient Data
The appendix is retrocecal and distended up to 20 mm, accompanied by peri-appendiceal fat stranding and some free fluid in the right subhepatic space and paracolic gutter. The right perirenal fasciae are also thickened due to inflammation. In addition, few tiny air bubbles are seen in the vicinity of the distended appendix, suggesting perforation.
In imaged portions of the lower thorax, a small volume of pleural effusion is present bilaterally, accompanied by mild adjacent lung collapse.
Case Discussion
Perforated retrocecal appendicitis in a 45-year-old patient with right lower quadrant abdominal pain for the past three days.
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