Perforated appendicitis - pediatric

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Right lower abdominal pain with fever and leukocytosis.

Patient Data

Age: 4 years
Gender: Female

The appendix is of retrocecal position, distended with fluid-filled and thickened and enhanced wall. There is a focal defect of the appendiceal wall with an adjacent fluid collection extending to the colonic gutter. Mesenteric fat stranding, with thickening and enhancement of the peritoneal reflections and reactive lymph nodes enlargement, are noted.

Annotated image

Annotated image showing the site of the appendiceal perforation (white arrow).

Case Discussion

CT features of a perforated acute appendicitis.

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