Case 314 Medical history Male patient, 16 years old, at the 2nd postoperative day (POD) after a video laparoscopic appendectomy, develops abdominal pain at the right hypogastric region, associated with fever, diarrhea, and hyporexia. CT scan of the abdomen and pelvis was performed. Image 1: Non-contrast-enhanced Computed Tomography (CT) image of the abdomen and pelvis, axial view, at the L5-S1 vertebral level. Image 2: Contrast-enhanced Computed Tomography (CT) image of the abdomen and pelvis, axial view, at the S3-S4 vertebral level, portal venous phase. Image 3: Contrast-enhanced Computed Tomography (CT) image of the abdomen and pelvis, coronal reconstruction, portal venous phase. Question:Considering the clinical history and the CT findings, which one is the most likely diagnosis? A) Free appendicolith associated with abscess formation B) Appendicular plastron C) Right ureteral obstruction due to urolithiasis D) Epiploic appendagitis Test question (Federal University of Goiás/UFG - MEDICAL RESIDENCY 2016 - Adapted)In acute appendicitis, the most accurate ultrasonographic finding is the presence of: A) Periappendicular fat blurring B) Diameter greater than 6 mm with obstruction C) Appendicolith D) Thickening of the appendicular wall E) Loss of compressibility Time is Up! Time's up
