PMC5733899_01
Coronal reconstruction demonstrating a drainage tube within the appendiceal collection.
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fig1
He was referred to our institution and underwent CT-guided drainage of the collection (Figure 1).
Coronal reconstruction demonstrating a persistent abscess in the retrocaecal region, with new extension to involve the pelvic side wall and iliopsoas muscles.
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fig2
An outpatient CT scan performed one month after the drainage for recurrent symptoms revealed a persistent abscess in the retrocaecal region, now extending to involve the pelvic side wall and iliopsoas muscles (Figure 2).
PMC5733899_02
Thickened and inflamed appendix with a focal perforation of the tip with an adjacent abscess.
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fig3
CT scan performed on admission delineated a dilated and ill-defined appendix with focal perforation at its tip (Figure 3).
Repeat CT scan demonstrates a largely stable periappendiceal collection.
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fig4
Repeat CT scan (Figure 4) demonstrated a stable collection and CT-guided drainage was performed.
A new hypodense lesion in caudate lobe of the liver suspicious for metastasis.
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fig5
The repeat CT scan (Figure 5) revealed an irregular lobulated mass with central necrosis at the ileocaecal junction associated with small bowel obstruction.
A persistent periappendiceal collection is again seen. New findings include small bowel obstruction as well as nodules adjacent to the collection and along the track of previous drain insertion.
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fig6
A new hypodense lesion in the caudate lobe of the liver was also identified, suspicious for a metastasis (Figure 6).