Acute appendicitis in pregnancy (MRI)

Case contributed by Vikas Shah , 23 Apr 2018
Diagnosis certain
Changed by Vikas Shah, 2 Mar 2021

Updates to Freetext Attributes

Description was added:

Histopathology

Macroscopic: Appendix covered in fibrinopurulent exudate 60x14mm.

Microscopic: This appendix shows abundant transmural acute inflammation and extensive tissue necrosis. There is no evidence of dysplasia or malignancy.

Conclusion: Appendix - acute gangrenous appendicitis

Updates to Case Attributes

Title was changed:
Acute appendicitis in pregnancy (MRI)
Body was changed:

The MRI findings are consistent with acute appendicitis with an inflammatory mass in the right side of the abdomen, and the findings were confirmed at surgery. Due to a change in the position of the appendix during pregnancy, localisation of pain varies. The position as seen here also made an ultrasound diagnosis difficult to make. MRI, where available, is recommended as the second line modality by the ACR Appropriateness Criteria 1,2.

Pathology

Macroscopic: Appendix covered in fibrinopurulent exudate 60x14mm.

Microscopic: This appendix shows abundant transmural acute inflammation and extensive tissue necrosis. There is no evidence of dysplasia or malignancy.

Conclusion: Appendix - acute gangrenous appendicitis

  • -<p>The MRI findings are consistent with acute appendicitis with an inflammatory mass in the right side of the abdomen, and the findings were confirmed at surgery. Due to a change in the position of the appendix during pregnancy, localisation of pain varies. The position as seen here also made an ultrasound diagnosis difficult to make. MRI, where available, is recommended as the second line modality by the ACR Appropriateness Criteria <sup>1,2</sup>.</p><p><strong>Pathology</strong></p><p><em>Macroscopic:</em> Appendix covered in fibrinopurulent exudate 60x14mm.</p><p><em>Microscopic:</em> This appendix shows abundant transmural acute inflammation and extensive tissue necrosis. There is no evidence of dysplasia or malignancy.</p><p><em>Conclusion:</em> Appendix - acute gangrenous appendicitis</p>
  • +<p>The MRI findings are consistent with acute appendicitis with an inflammatory mass in the right side of the abdomen, and the findings were confirmed at surgery. Due to a change in the position of the appendix during pregnancy, localisation of pain varies. The position as seen here also made an ultrasound diagnosis difficult to make. MRI, where available, is recommended as the second line modality by the ACR Appropriateness Criteria <sup>1,2</sup>.</p>
Presentation was changed:
28 weeks/40 pregnant. Right upper quadrant pain and fever. No abnormality detected on ultrasound.

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Acute appendicitis in pregnancy
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