Perforated Appendicitis Complicated Appendicitis with Perforations Estimated reading: 1 minute 138 views Clinical History A 19-year old male presented with a 4-day history of abdominal pain radiating to the right iliac fossa, some fever, diarrhoea, and vomiting. Blood tests revealed elevated inflammatory markers. Case Description Ultrasound revealed a 98 x 43 x 58 mm heterogeneous hypoechoic area in the right iliac fossa posterolateral to the caecum and anterior to the psoas muscle fibres. Also, there was mesenteric fat stranding around it. These were all at the site of the patient’s maximum tenderness. The normal appendix tissue was not seen leading the sonographer to raise the suspicion of appendiceal perforation. Diagnosis/ Discussion/ Treatment/ Follow up The patient had an emergency appendectomy and the surgical specimen analysed histologically confirmed the diagnosis of perforated appendicitis. Sonograms Sonogram acquired using a high frequency linear probe showing a heterogeneous hypoechoic structure in the RIF Sonogram acquired using a curvilinear probe showing a heterogeneous hypoechoic structure in the RIF Sonogram acquired using a curvilinear probe showing a heterogeneous hypoechoic structure in the RIF Power Doppler showing no evidence of vascularity Sonogram acquired using a high frequency linear probe showing a heterogeneous hypoechoic structure in the RIF Panoramic view of the RIF Published on: October 9, 2024
