The patient proceeded to appendicectomy. 

Histopathology

MACROSCOPIC DESCRIPTION: "Appendix": An appendix 75 mm in length, up to 15 mm in width with minimal mesoappendix attached. The serosa is covered by a pale brown thick exudate. On cut section a hard, yellow, 20 x 14 x 10 mm faecolith is present. No perforation or solid tumours are seen.

MICROSCOPIC DESCRIPTION: Sections of appendix show transmural acute neutrophilic inflammation including serositis. There is haemorrhagic necrosis of mucosa. No perforation is seen. There is no evidence of dysplasia or malignancy.

DIAGNOSIS: Acute suppurative appendicitis, faecalith.

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