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Insights into Imaging
Fig. 6 | Insights into Imaging

Fig. 6

From: Pictorial review of normal postoperative cross-sectional imaging findings and infectious complications following laparoscopic appendectomy

Fig. 6

A 22-year-old male with AA preoperatively diagnosed with unenhanced MDCT (a) revealing a distended, thickened appendix (arrow) with a small calcified appendicolith, surrounded by right-sided fascial fluid and perivisceral fat stranding. Intraoperative and pathological findings diagnosed phlegmonous AA. Two weeks after LA, persistent fever, leukocytosis (13,500/mmc) and increased lipase and C-reactive protein values (380 mg/l) led to repeated contrast-enhanced MDCT. Imaging showed subphrenic (thin arrows in b) and infrahepatic (arrowheads in b and c) collections: the former with enhancing serosa, the latter with thickened enhancing borders abutting the lateroconal fascia. Laparoscopic exploration confirmed subhepatic and right subphrenic abscesses; conversion to laparotomy was necessary to drain collections and clean the peritoneal cavity. The subsequent postoperative course was further complicated by right-sided pneumonia and pleural effusion

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