Presentation
Right lower quadrant pain, leukocytosis with neutrophilia - appendicitis?
Patient Data
The scan was performed using split bolus timing - the renal collecting systems are opacified and a urinary jet from the left ureter is visible.
The appendix courses caudally, its proximal half fills up with contrast material, and it is of normal thickness throughout. No periappendiceal fat stranding.
Horseshoe-shaped diverticulum around the proximal urethra, exhibiting an enhancing wall and surrounding the anterior and left aspects of the urethra.
Right ovary - corpus luteum and several follicles.
Case Discussion
Presented with low abdominal pain, more pronounced on the right, with guarding and rebound tenderness. WBC 15.3 K/uL, neutrophils 86.3%. The appendix could not be located on ultrasonography. The CT study showed a normal appendix and a hitherto unknown urethral diverticulum.
A urology consultation was ordered:
A cystic mass was palpated through the vaginal wall over the urethra and to its left. On compression, a small amount of urine flowed through the urethra.
Regrettably, the case was lost to follow-up.
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