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Appendicular abscess

Case contributed by Bassem Marghany
Diagnosis almost certain

Presentation

Right iliac fossa pain for several days, mild leukocytosis.

Patient Data

Age: 40 years
Gender: Male
ultrasound

Distended non-compressible appendix (diameter = 8 mm).

Surrounding heterogeneous mixed echogenicity mass/abscess formation. 

No appendicolith detected.

Case Discussion

The patient presented with a history of abdominal pain over 2-3 weeks, which was initially moderate (5/10) followed by sudden relief of pain for 1-2 days. Pain then recurred for a few days after which the patient sought medical advice. The initial diagnosis of acute appendicitis was missed.

Following the radiological diagnosis of appendicular abscess, the patient was admitted for further management, where he received IV antibiotics and was scheduled for surgery. 

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