45/Female with Severe pain abdomen. on examination severe pain in RIF WITH REBOUND TENDER, Vomiting (+) WBC: 27000 ATTACHED CT ABDOMEN

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Clinically looks like acute inflamtory or infective condition causing intestinal obstruction ....However CT shows abnormality near periamoullary area ,around head of pancrease and distal CBD probably inflammatory mass causing obstruction... Best would be tri phasic CT for confirmation...till ten keep NPO , start on antibiotics and IV fluids..

Thank you so much Doctor ..
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RIF pain rebound tenderness leucocytosis and gross central IHBRD on CT need to be further evaluated. Is there jaundice?

Lft is WNL SIR
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Ac appendicitis !burst urgent surgery should be think of.

History suggests inflammation infection with fluid level seen in CT abdomen see liver lesion may be ruptured appendicitis with peritonitis

What was the diagnosis finally...what was the CT reporting..?

Ac.appendicitisburst .Emergency surery to be undertaken.

Thank you doctor
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Due to appendicitis brust its tends to sepsis that why go for immediat surgery

Acute Appendicitis with peritonitis

@Dr. Syam Sundar Patro

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