Day: February 8, 2024

School ager with right lower quadrant pain and fever

US and CT of acute appendicitis with perforation with an appendicolith and a pelvic abscess
Sagittal US of the right lower quadrant (above left) shows a dilated, non-compressible, blind ending tubular structure between the calipers while a transverse US of the right lower quadrant (above right) shows echogenic fat surrounding an oval echogenic structure in the center of the image that has posterior shadowing. Axial CT with intravenous and oral contrast of the abdomen (below) shows a large cystic and septated mass in the center of and to the right of the pelvis that has an oval calcification in it anteriorly.

The diagnosis was acute appendicitis with perforation with an appendicolith in the center of a pelvic abscess.