Acute appendicitis - long appendix

Case contributed by Dr Ian Bickle

Presentation

Acute abdomen with whole tummy peritonism. Urgent CT to rule out appendicitis.

Patient Data

Age: 20 years
Gender: Male

Very long, thickened fluid filled appendix with a 4 mm appendicolith at the ostium.

The appendix measures more than 10 cm and extends cranially medial to the external iliac vessels with the tip in the right para midline at the level of the L5/S1 disc space.

Trace of free fluid in the pelvis.

Normal upper abdomen.

Case Discussion

I thought I would share this one as it demonstrates how variable the appendix can be in length and location.

I have seen plenty of acute appendicitis on imaging over the years, but this is by far the longest appendix I have ever observed at between 10-11 cm. 

Just for sharing.

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Case information

rID: 85837
Published: 14th Jan 2021
Last edited: 14th Jan 2021
Inclusion in quiz mode: Included

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