Presentation
Deep pelvic pain for five days was associated with nausea, vomiting, constipation, and increased inflammatory markers.
Patient Data
A dilated appendix with a maximum diameter of 8 mm shows a fluid-filled lumen and thick enhanced walls with a small appendicolith noted at its base. The appendix tip, reaching the upper pre-rectal region with areas of loss of wall integrity associated with early formation of fluid collection, measures roughly 36 x 28 mm, extending to the Douglas pouch.
The diagnosis was made as acute pelvic appendicitis with a high suspicion of perforation complicated by abscess formation.
Otherwise, normal.
Operative notes:
Incision:
Right grid iron incision.
Findings:
A perforated pelvic appendix with a small amount of thick pus in the pelvis.
Procedure:
the appendix was separated from its adhesions
the mesoappendix was ligated and cut
the appendix was transfixed at the base and cut
a pus swab was taken, and lavage was done
a medium drain was kept as a large drain was not available
Case Discussion
Appendicular abscess is considered the most prevalent consequence of acute appendicitis, especially on the fifth to tenth day after a perforated appendix.
I would like to thank Dr. Aftab Hussain, SQH Pediatrics Surgery Department, for his valuable operative notes.
Unable to process the form. Check for errors and try again.