Presentation
1 week worsening RIF pain, sharp/burning in nature. WCC 20, CRP 135.
Patient Data
No previous cross-sectional body imaging available at the time of reporting.
Lung bases clear with several prominent air cysts, probably related to advanced age.
~6 cm proximal to the ileocecal valve is acute inflammation of a focal outpouching of the mesenteric border of the terminal ileum suspicious for acute diverticulitis of the ileum, a further non-inflamed diverticulum is present just upstream from the inflamed diverticulum. Unremarkable appendix. Local mildly enlarged reactive nodes. No free fluid or gas.
Scattered diverticulosis of the colon, especially of the sigmoid colon, without diverticulitis.
Moderate hiatus hernia. Decompressed stomach.
Diffuse decreased hepatic density may represent steatosis. No CT visible stones in the gallbladder. Mild biliary dilatation without visible filling defects. Portal and hepatic veins patent. Spleen, pancreas, adrenals and kidneys unremarkable.
Bilateral prominent fat in the proximal inguinal canals consistent with inguinal hernias, these may be subclinical.
No vertebral compression fractures. No suspicious bone lesions.
Conclusion:
Acute diverticulitis of the terminal ileum. No evidence of perforation or abscess.
I do not think this is Meckel diverticulitis as the abnormality arises from the mesenteric border.
Case Discussion
Acute diverticulitis of the terminal ileum is a rare condition.
Patient was managed conservatively and made an uneventful recovery.
Unable to process the form. Check for errors and try again.