Perforated retrocaecal appendix

Case contributed by Dr Ian Bickle

Presentation

Right iliac fossa pain. Clinical concern of a underlying malignancy.

Patient Data

Age: 60 years
Gender: Female

The proximal appendix is thickening with discontinuity of the mid-portion. Calcified appendicolith at the ostium. Surrounding this is an approximately 4cm air-fluid filled collection.

7cm collection in the vesicouterine pouch with an air-fluid level.

Several dilated loops of small bowel and intensive inflammatory change in the mesentery.

Fatty liver.

Case Discussion

This case represents one of the nastier presentations of appendicitis with perforation and associated complication of intra-abdominal collections.

Laparotomy report

300mls of pus and faeculent material in the abdomen.

Retrocaecal appendix with large perforation in the mid-portion.

Adherent dilated small bowel.

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Case information

rID: 55440
Case created: 6th Sep 2017
Last edited: 9th Sep 2017
Inclusion in quiz mode: Included

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