Demographics:
72 years old, Male
Indication:
Abdominal pain, leukocytosis
Findings
Lower chest
- Mild dependent atelectasis/scarring
- Moderate coronary artery calcification
Abdomen/Pelvis
- Distended, fluid-filled appendix measuring up to 14 mm in diameter with poor definition of wall of the appendiceal tip
- Adjacent extraluminal fluid and gas in the right hemiabdomen without clear peripheral enhancement
- Mildly nodular hepatic surface contour with left lobe hypertrophy
- Ill-defined hypoattenuating lesion in hepatic segment 7 measuring approximately 2.5 cm and extending to the capsule
- Scattered colonic diverticula without evidence of acute diverticulitis
- Prostate is enlarged, measuring 5.7 cm in transverse diameter
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
MSK
- No acute findings
- Tiny fat-containing periumbilical hernia
Diagnosis
Perforated appendicitis
Sample Report
Findings concerning for acute perforated appendicitis. Recommend surgical evaluation.
Cirrhotic liver morphology with an indeterminate hypoattenuating lesion in hepatic segment 7, which may represent the result of portal branch thrombosis but warrants further evaluation with nonemergent liver protocol MRI to exclude neoplasm.
Discussion