Presentation
Abdominal pain.
Patient Data
Pre and post-contrast abdominal CT scan show distended and thickened appendix with appendicolith inside. The tip of the appendix is not clearly visualized and its blend with nearby air containing fluid collection consistent with perforation and abscess formation. The adjacent bowel loops are thickened with fat stranding and some loops are in close proximity to each other that goes with an indolent inflammatory response.
Free pelvic and perihepatic fluid are noticed.
Case Discussion
It is important to take the attention of the appendix in many cases of pelvic pathology. By identifying the cecum firstly and then the ileum you can catch the appendix in the easiest way.