These findings described at the level of the right iliac fossa are compatible with complicated acute appendicitis with appendicular abscess. Appendicular abscess is the most common complication of acute appendicitis following rupture of the inflamed and distended appendix. An appendicolith is thought to be a predisposing factor for perforation. Perforation of the appendix is more common among the elderly population due to an increased frequency of late and atypical presentation of appendicitis, delay in diagnosis, delayed decision for surgery and to the age-specific physiological changes.
An appendicular abscess can be managed by either surgical drainage or by image guided percutaneous drainage. The appendix is subsequently removed at interval appendectomy.