Presentation
Abdominal pain for 3 days, right lower quadrant tenderness. Febrile with neutrophilic leukocytosis.
Patient Data
The appendix is enlarged measuring approximately 15 mm in diameter, thick-walled with inadequate wall integrity. There is peri-appendicular fat stranding and adjacent free fluid, extraluminal gas as well as a distal appendicolith at its base, approximately 10mm in diameter.
There are multiple tiny air foci surrounding the appendix as well as right peri-hepatic subphrenic free air consistent with pneumoperitoneum.
Case Discussion
A markedly dilated appendix with adjacent extra-luminal air on CT is most consistent with complicated acute appendicitis with perforation.
He underwent a successful laparoscopic appendectomy with an abdominal drain in situ.
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