Presentation
Left iliac fossa pain associated with fever and vomiting since 3 days. Tenderness and guarding present.
Patient Data
Age: 40 years
Gender: Female
From the case:
Intestinal non-rotation with left sided acute appendicitis
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- intestinal non-rotation with cecum in the left iliac region. A tubular blind ended structure measuring approximately 10 mm in diameter with adjacent fat stranding is seen, likely inflamed appendix.
- liver and spleen are enlarged in size.
- a well-defined lobulated hypo-/isodense area with gradual filling in of contrast and persistent enhancement on delayed images is seen in segment V of the right lobe of liver, likely a hepatic hemangioma.
Case Discussion
Acute appendicitis can present with wide varieties of symptoms and clinical signs. This is a rare case of left sided acute appendicitis with incidental diagnosis of intestinal non-rotation. Atypical presentation of appendicitis in left iliac fossa can be easily misdiagnosed. CT plays a vital role in diagnosing these conditions.
Exploratory laparotomy was done which revealed left sided acute appendicitis. Patient was discharged subsequently on 3rd day of appendectomy.
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