Appendicitis with perforation
3 day history of increasing abdominal pain and constipation for 2 days. Past Medical History of Crohn's Disease.
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Mildly thick-walled retrocecal appendix measuring 11 mm in transverse diameter. Adjacent to the appendiceal tip, there is a small low-density collection with a single intraluminal gas locule, consistent with local perforation. Additional small locules of free gas adjacent to the appendix and elsewhere within the right side of the abdomen. Mild peri-appendiceal inflammatory stranding. Prominent mesenteric nodes measuring up to 12 mm in transverse diameter. Mild circumferential wall thickening of the terminal ileum in keeping with Crohn's disease without definite active inflammation.
Perforated appendicitis with small volume periappendiceal fluid collection and trace pneumoperitoneum.