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Sunday, 20 April 2014

CASE 249: RLAQ MASS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM


Woman 56 yo, pain in RLAQ for 2 weeks, fever and GI tract trouble with diarrhea was treated  by  antibiotics.
Ultrasound detected one mass at RLAQ, suspected appendicular abscess or coecum tumor (see 4 US pictures).





Blood test  WBC= 17K with 17% neutro.
MSCT with CE  shows  this mass  being wall-off  by  instestine,  central part is  liquide as pus collection (see 3 CT pictures).




What is your suggestion of diagnosis and what is  the another test needed for make sure diagnosis?.
Open operation  detected  this mass at  RLAQ  is abscess due to appendicular necrosis.



DISCUSSION: TRIPLE TEST  of appendicitis is blood tests  for diagnosis of acute or   appendicula abscess including 3 criteria: WBC, NEUTRO%  and CRP.

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