EURORAD ESR

Case 12133

Fulminant necrotising fasciitis from subclinical appendicitis

Author(s)
Chin TY, Wong JJ, Haworth A

Arrow Park Hospital,
Wirral, Merseyside,
United Kingdom;
Email:teck.chin82@gmail.com
 
Patient
male, 84 year(s)
 
 
  • Figure 1
    AP/Oblique radiographs of the pelvis and right hip
     

    Initial presenting radiographs.

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Acute;

    Initial presenting radiographs

     
    Area of Interest: Musculoskeletal system; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    Pelvic and femur radiographs
     

    AP/Lateral pelvis and lateral right femur acquired 1 day later.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Infection;

    AP/Lateral pelvis and lateral right remur acquired 1 day later.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Infection;

    AP/Lateral pelvis and lateral right femur reveals gas locules along the muscular fascia and tissue planes.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 3
    Non contrast CT abdomen/pelvis
     

    Selected axial and sagittal slices through the lower abdomen/pelvis reveal an inflammatory abscess in the right iliac fossa. Note the focus of calcification within it.

     
    Area of Interest: Abdomen; Musculoskeletal soft tissue; Pelvis; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Abscess; Infection;

    Selected axial and sagittal slices through the lower abdomen/pelvis reveal an inflammatory abscess in the right iliac fossa. Note the focus of calcification within it.

     
    Area of Interest: Abdomen; Musculoskeletal soft tissue; Pelvis; Imaging Technique: CT; Procedure: Ablation procedures; Diagnostic procedure; Special Focus: Abscess; Infection;
     
     
  • Figure 4
    Non-contrast CT axial images
     

    Selected axial images demonstrating inflammatory change around the muscular bundles of the right iliopsoas, with gas locules tracking into the anterior, posterior and adductor muscle groups.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Selected axial images demonstrating inflammatory change around the muscular bundles of the right iliopsoas, with gas locules tracking into the anterior, posterior and adductor muscle groups.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;

    Selected axial images demonstrating inflammatory change around the muscular bundles of the right iliopsoas, with gas locules tracking into the anterior, posterior and adductor muscle groups.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 5
    CT-guided drain insertion

    CT-guided drain insertion via a Merit One Stop 5F 15 cm centesis catheter.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Drainage; Special Focus: Abscess;
     
     
Initial presenting radiographs.
 
Initial presenting radiographs
 
AP/Lateral pelvis and lateral right femur acquired 1 day later.
 
AP/Lateral pelvis and lateral right remur acquired 1 day later.
 
AP/Lateral pelvis and lateral right femur reveals gas locules along the muscular fascia and tissue planes.
 
Selected axial and sagittal slices through the lower abdomen/pelvis reveal an inflammatory abscess in the right iliac fossa. Note the focus of calcification within it.
 
Selected axial and sagittal slices through the lower abdomen/pelvis reveal an inflammatory abscess in the right iliac fossa. Note the focus of calcification within it.
 
Selected axial images demonstrating inflammatory change around the muscular bundles of the right iliopsoas, with gas locules tracking into the anterior, posterior and adductor muscle groups.
 
Selected axial images demonstrating inflammatory change around the muscular bundles of the right iliopsoas, with gas locules tracking into the anterior, posterior and adductor muscle groups.
 
Selected axial images demonstrating inflammatory change around the muscular bundles of the right iliopsoas, with gas locules tracking into the anterior, posterior and adductor muscle groups.
 
CT-guided drain insertion via a Merit One Stop 5F 15 cm centesis catheter.
 
 
 
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