Case report
A 45 years male presented to the emergency department of Dadeldhura
hospital, Nepal with pain in right iliac fossa for 4 days associated
with low grade fever, nausea, vomiting and anorexia. His bowel and
bladder habits were normal. On examination, the patient was febrile with
tenderness and guarding in right iliac fossa. His hernial orifices were
intact and bowel sounds were present.
Ultrasonography of abdomen showed acutely inflamed appendix with early
lump formation and his total white blood cell count was 16000
mm3. Emergency open appendectomy was done which
revealed an inflamed retrocecal appendix with lump measuring
approximately 18 cm in length with perforation at the shaft of appendix
(Figure 1). Histopathological examination of the specimen showed acutely
inflamed appendix. His postoperative hospital stay was uneventful and
discharged on third postoperative day.