Test Yourself

Case 1

HISTORY

A young woman complained of three days of lower abdominal and right iliac fossa pain. On examination there was an ill defined mass in the right iliac fossa at the point of maximal tenderness.

ULTRASOUND FINDINGS

A rounded mass was seen in the right iliac fossa, overlying the iliac vessels. The mass is hetrogenous with a predominantly echolucent areas posteriorly. Within the superior portion of the mass there is a blind ended tubular structure which, on high frequency imaging, displays layers suggestive of "bowel signature". This is suggestive of the appendix. There is increased echogenicity of the fat surrounding the mass suggesting inflammation.

DISCUSSION

The position of the abscess and clinical history suggested appendiceal abscess as the most likely diagnosis. It is uncommon to see the appendix within the abscess as perforation can result in "deflation" of the previously tense appendix and necrosis can cause loss of the usual layers of the bowel signature, which makes it more difficult to identify the appendix.

SUBMITTED BY

Adrian Goudie


Right Iliac Fossa, trans

Right Iliac Fossa, trans

A rounded mass is seen in the right iliac fossa
Right Iliac Fossa, trans Right Iliac Fossa, trans Right Iliac Fossa, long Right Iliac Fossa Mass RIF Mass, trans RIF, High Frequency RIF, High Frequency RIF, High Frequency