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Abdomen » Appendix
Acute appendicitis in a subhepatic location
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Author(s) :
Ravi Kadasne, MD
 
Presentation This is the scan in a 17-year-old boy with severe pain in the right upper and lower quadrants.
 
 
 
Caption: Transverse and oblique scans of the right upper quadrant
Description: A tubular fluid distended structure is seen in the right upper quadrant. This structure was not compressible, was tender on scanning and could be traced arising from the right lower quadrant.
 
 
 
Caption: Scans of the right lower quadrant
Description: The tubular non-compressible structure most likely represents an inflamed appendix. The inflamed appendix can be traced coursing upwards with its tip lying in a subhepatic location, in close proximity to the edge of the liver and lower pole of the right kidney [as marked by the arrows].
 
 
 
Caption: Views of the right upper quadrant
Description: The inflamed appendix as marked by the arrows is seen here, with the tip of the appendix demonstrating a curvilinear shadowing appendicolith.
 
 
 
Caption: Photograph of the pathology specimen at surgery
Description: The enlarged and inflamed appendix [measuring approximately 13 mm in length] is seen in this photograph. The ultrasound finding of the subhepatic location of the appendix was confirmed at surgery.
 
Differential Diagnosis Acute appendicitis
 
Final Diagnosis Acute subhepatic appendicitis
 
Follow Up The patient was operated and the inflamed appendix was removed at surgery.
 
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