Presentation
Referred from a nursing home, unable to give precise history due to mental disability, mild malaise and anorexia 7 days prior, progressing to septic shock at admission.
Patient Data
Mild to moderate ascites, omental and mesenteric fatty haziness and few extraluminal air bubbles are noted. An inflamed appendix containing an appendicolith is seen in the right paracolic gutter with foci of mural discontinuity and adjacent extraluminal air bubbles in the appendiceal base suggestive of perforated gangrenous appendicitis.
No abscess nor sign of phlegmon formation was detected.
Case Discussion
Although peritonitis is a clinical term, peritonitis due to perforated hollow viscus should be considered.
The patient was septic and underwent emergent surgery. Peritonitis with pus and fibrin in the peritoneal cavity and gangrenous appendix with perforation was found at surgery.
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