a28 yrs old lady having fever since 20 days with headache ... all blood test c.b.c.,widal,l.f.t.,r.f.t.,are normal I attached u.s.g abdomen which suggest acute appendicitis with few messenteric lymphnode enlargement ... please give ur valuable opinions Thanks

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I agree with usg report that it is subacute subclinical appendicitis with mesenteric lymphadenopathy Meckle's diverticula is not in RIF it is alwayd on lt paraumbilical region So far complaints of pain abdomen is concerned since it is subacute and coincidental finding we can not ask for it Yes fever is concerned and ie for 20 days That is along with mesenteric lymphadenopathy does give suspicions of koch's abdomen and hence ct abdomen mt esr sos lymphnode biopsy will help.
Thank you sir
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It is unlikely that this patient is suffering from acute appendicitis, since she has not complained of pain abdomen , anorexia or vomiting .. Abdominal Lymphnode may be because of mesenteric adinitis . The tubular structure may be MECKELS DIVERTICULUM . CT / MRI ABDOMEN MAY THROW SOME LIGHT Antibiotics, metronidazole can be added Biopsy of abdominal lymph nodes may give a clue .
Appendix if visualised on USG with out any abdominal pain needs evaluation. A CECT abdomen can be helpful. Considering mild interloop fluid and mesentric lymphadenitis possibilities of Abdominal tuberculosis Adenocarcinoma appendix Meckel's diverticulitis Crohn's disease Are there
It is not appendicitis..do guided FNAC from lymph nodes and ascitic fluid..send for TB, almost confirm TB abdomen APPENDICITIS without pain abdomen and leukocytes : definitely not appendicitis.
yes agree with @Dr. Krishnan Pichumani less likely to be appendicitis. requires CECT abdomen.
Give syptamatical for apedicities further evavulation for kochs abdonan do ct abdomen if chrons divercullitirs abd tb then go for it after first syptamatic
Not all appendicitis presents with classical signs and symptoms. Seems recurrent/subacute appendicitis. Adv: Appendicectomy
Only treatment is apendisectomy, or it will burst causing peritonitis don't worry about lymph glands.
I did agree with my own advise ask did not read the full well I did agree with my own suggestions, I was in a flight and not see the full presentation. Without tenderness in the rt. Iliac fossa, vomitting , guarding , rebound tenderness, it can't be appendicitis. You investigate in the line of p u o ,like urti chest infection malaria , typhoid etc. There was no indication for USG.
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Mostly suggesting TB abdomen. Abdominal Paracentesis to confirm the diagnosis.
Seems to be recurrent / subacute appendicitis. Adventure.. Appendicetomy.
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