Acute appendicitis in pregnancy

Discussion:

The MRI findings are consistent with acute appendicitis with an inflammatory mass in the right side of the abdomen, and the findings were confirmed at surgery. Due to a change in the position of the appendix during pregnancy, localization of pain varies. The position as seen here also made an ultrasound diagnosis difficult to make. MRI, where available, is recommended as the second line modality by the ACR Appropriateness Criteria 1,2.

Pathology

Macroscopic: Appendix covered in fibrinopurulent exudate 60x14mm.

Microscopic: This appendix shows abundant transmural acute inflammation and extensive tissue necrosis. There is no evidence of dysplasia or malignancy.

Conclusion: Appendix - acute gangrenous appendicitis

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