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21 paź 2024 · A perforated appendix is one of the complications of acute appendicitis. When appendicitis is left untreated, necrosis (gangrene) of the appendiceal wall can occur and progress to a focal rupture. Epidemiology. The rate of perforated appendix vary from 16% to 40%, with higher incidence in younger age group and in patients older than 50 years 9.
Laboratory results, RLQ tenderness, and US findings are congruent with appendicitis. The wall changes and surrounding fluid suggest necrosis/gangrene and presage perforation. An urgent operation was performed which found: perforated appendicitis.
If appendicitis is allowed to progress, portions of the appendiceal wall eventually become ischemic or necrotic [1, 59] and the appendix perforates. On CT, perforation is suggested by the presence of localized periappendiceal inflammation, although this is a nonspecific finding.
1 wrz 2020 · The presence of air outside the appendix is a classical finding of perforated appendicitis. A tip to identify perforation in the absence of extra-luminal air is to carefully look for an interruption of the wall, either using colour flow Doppler or on enhanced CT: focal loss of vascularization or enhancement suggests perforation.
The vermiform, edematous appendix markedly lengthens with its distal tip extrinsically abutting the right lower renal pole region. No appendicoliths or fecoliths or gross lymphadenopathy. Mild right iliac fossa free fluid is noted accompanied wit...
Right lower quadrant peritoneal/serosal thickening and enhancement, particularly the cecal base. Enlarged and irregular appendix, with a small appendicolith near the tip. Tiny dot of extraluminal air along the inferior appendix.
A statistically significant association was found between three sonographic findings and perforation: loculated pericecal fluid, prominent pericecal fat, and circumferential loss of the submucosal layer of the appendix. No single finding had a specificity greater than 59%.
