Short history of right lower abdominal pain. Peritonitic on examination. Perforated appendix?
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Long thick walled fluid-filled appendix with a 6mm obstructing appendicolith at the ostium.
The tip of the appendix lies in the midline with multiple locules of peri-appendiceal free gas and inflammatory change centered on the mid-portion of the appendix.
All the juicy features of an inflamed and perforated appendix with the typical obstructing appendicolith as the ostium.
Bread and butter radiology and increasingly more so with CT imaging.