A 50-year old man presented with a 1-week history of aggravating right lower quadrant tenderness along with diarrhea, vomiting, and fever. He was taking loperamide from which he got some relief in symptoms. He denied any history of melena, hematochezia, or weight loss. Medical history Besides open hemorrhoidectomy, he had no significant medical history. He had no family history of intestinal disorders.
Vital signs Temperature:39⁰C Heart rate:102 beats/minute Abdominal examination Localized tenderness with fullness and guarding in the right lower quadrant. Laboratory examination Leukocytes: 17000 cells/mm 3 C-reactive protein: 205 mg/L Computed Tomography (CT) of abdomen and pelvis with intravenous contrast: It indicated a right-sided 7.5 cm inflammatory mass with air and fluid, as well as a calcified deposit within the appendix (appendicolith). Figure 1 . Transverse CT…
