Student Image Challenge #73
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The case illustrate the difficulty of differentiating the appendix from the last ileal loop, which also suffers inflammatory focal changes in appendicular peritonitis.
Images 1 and 2 reveal the last ileal loop which does not keep the parietal changes and especially, it does not present significant mesenteric thickening, which automatically accompany the inflammatory process.
The appendix was detected retrocecally, laterally to the ascending colon, a rare anatomical variant. The changes in the periapendicular space define the extent of the inflammatory process.The convex probe highlights the latero-cecal inflammatory block, centered by the appendix.
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Case courtesy of Dana Nedelcu MD
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