Presentation
Right lower abdominal pain for two days associated with vomiting.
Patient Data
Enlarged hyper-enhancing retrocecal appendix measuring approximately 14 mm in diameter with its tip lying in the subhepatic location. Fat stranding and minimal free fluid is noted around the appendix. No radiopaque appendicolith is seen. No sizable fluid collection or pneumoperitoneum is seen.
Enlarged liver measuring approximately 20 cm, small nonobstructive right renal calculus measuring 3 mm, small fat-containing umbilical hernia and minimal bilateral pleural effusions. Mildly bulky uterus with thickened endometrial stripe. A well-defined nonenhancing hypodensity measuring 18 x 27 mm is seen in the left adnexa which is likely an ovarian follicle. Another well-hypodensity measuring 15 x 19 mm showing peripheral enhancement is seen in the left adnexa which may be a ruptured follicle/luteal cyst.
Case Discussion
Radiological features are consistent with acute appendicitis. Laboratory investigations showed leukocytosis. Following the work up, the patient underwent an uneventful laparoscopic appendectomy.