Perforated pelvic appendicitis

Case contributed by Ammar Haouimi ◉

Diagnosis almost certain

Citation, DOI, disclosures and case data

Citation:

Haouimi A, Perforated pelvic appendicitis. Case study, Radiopaedia.org (Accessed on 04 Oct 2023) https://doi.org/10.53347/rID-84719

DOI:

https://doi.org/10.53347/rID-84719

Permalink:

https://radiopaedia.org/cases/84719

rID:

84719

Disclosures:

At the time the case was submitted for publication Ammar Haouimi had no recorded disclosures.

View Ammar Haouimi's current disclosures

Case published:

3 Dec 2020

Revisions:

1 time, by 1 contributor - see full revision history and disclosures

Systems:

Gastrointestinal

Tags:

appendicitis, perforated appendix, appendicolith

Institution:

Aurès Medical Imaging Center - Batna Algeria

Quiz mode:

Included

Presentation

Right lower abdominal pain with fever, tenderness, and leukocytosis.

Patient Data

Age: 60 years

Gender: Female

From the case: Perforated pelvic appendicitis

mri

The MRI sequences demonstrate:

a pelvic appendix, dilated (10 mm) with thick enhanced wall and focal defect at the appendiceal tip (see annotated images)
pelvic free intraperitoneal fluid with small floating internal hypointense structures on T2 sequences, representing certainly the extraluminal appendicoliths (see annotated images)
regular thickening with enhanced peritoneal reflections (pelvic peritonitis)
note artifact within the cecum

From the case: Perforated pelvic appendicitis

Annotated image

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Annotated images:

red arrows: inflamed appendix
yellow arrow: perforated appendiceal tip
blue arrow: extraluminal appendicoliths

Case Discussion

MRI features of perforated pelvic appendicitis with secondary pelvic peritonitis.

Perforation of the appendix is more common with advanced age (as in this case), due to an increased frequency of late and atypical presentation of appendicitis, Perforated appendicitis within the pelvis is seen in around 30% of cases.

Perforated pelvic appendicitis

Citation, DOI, disclosures and case data

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Perforated pelvic appendicitis

Citation, DOI, disclosures and case data

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Patient Data

Case Discussion

2 articles feature images from this case

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