Perforated appendicitis

Case contributed by Michael P Hartung
Diagnosis certain


Abdominal pain.

Patient Data

Age: 50
Gender: Male

Dilated, irregular, and fluid-filled appendix with a discontinuous wall in the midportion along the anterior margin, consistent with perforation. Just proximal to the site of perforation there is an appendicolith.

No discrete or drainable fluid collection. No other acute findings.

Case Discussion

This is a classic case of perforated appendicitis. Within the proximal/mid appendix there is an appendicolith. Just beyond the appendicolith, the appendix becomes dilated, irregular, and fluid-filled. Along the anterior margin there is a site of discontinuous mucosal enhancement with adjacent phlegmon, consistent with perforation. No other organized or drainable fluid collections are present.

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