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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.
The wall changes and surrounding fluid suggest necrosis/gangrene and presage perforation. An urgent operation was performed which found: perforated appendicitis. appendix, cecum and terminal ileum conglomerate inflammatory mass.
The appendix is enlarged measuring approximately 15 mm in diameter, thick-walled with inadequate wall integrity. There is peri-appendicular fat stranding and adjacent free fluid, extraluminal gas as well as a distal appendicolith at its base, approximately 10mm in diameter.
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.
Walizai T, Perforated appendix. Case study, Radiopaedia.org (Accessed on 26 Jun 2024) https://doi.org/10.53347/rID-183440
10 sty 2016 · Abscess and extraluminal air are the most specific findings for perforated appendicitis, but have low sensitivity. Periappendiceal inflammatory stranding and focal defect in the enhancing appendiceal wall are more sensitive, but less specific.
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.
