0:00

Alright. So perforated appendicitis, it's a dreaded outcome

0:04

of appendicitis when we do not image or diagnose

0:07

problem as soon as we should. On imaging, you may see

0:11

that focal wall defect, which indicates perforation.

0:14

You may see a fluid abscess.

0:16

Even with enhancing walls, you

0:18

can have extraluminal gas.

0:19

I haven't seen that very often, and

0:21

they usually are small little locules.

0:22

I mean, I've seen it, but it's

0:24

not as extensive as you'd expect.

0:26

It's usually just small little locules of extraluminal air.

0:29

And you may actually see the append

0:31

luminal, like it's just spit itself out

0:33

and it's free floating in the abdomen.

0:35

We always try to measure if

0:36

there is a fluid collection.

0:38

Our interventionalists like a three centimeter

0:40

fluid collection whenever possible to put in a drain.

0:43

Our surgeons will defer, um, doing

0:45

surgery in acute perforated appendicitis.

0:48

They would choose rather to give antibiotics

0:50

and do what's called an interval appendectomy,

0:52

which is done at some point in a delayed fashion.

0:55

In order to remove the appendix, and we'll use a lot

0:58

of interventional drainage catheters in these patients.

1:01

So it's a dreaded outcome of appendicitis.

1:04

I would say most of our appendicitis

1:07

imaging cases are early in the evolution of

1:11

disease, so we're very fortunate for that.

1:13

But at times, we do have to make the diagnosis of

1:15

perforated appendicitis and bring in more extensive

1:19

medical teams, including our interventional colleagues.

Perforated Appendicitis

HIDE

Prev Next

Interactive Transcript

Pro Tip: Click on a word in the transcript to jump to that point in the video