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Case Rep Radiol. 2013;2013:584925. doi: 10.1155/2013/584925. Epub 2013 Feb 11.

Perforation of a retrocecal appendix resulting in retroperitoneal air: a case report.

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Departments of Radiology and Surgery, Cooper University Hospital, Cooper Medical School of Rowan University, One Cooper Plaza, B23, Camden, NJ 08103, USA.


There have been several case reports documenting acute appendicitis complicated by perforation presenting with retroperitoneal abscess formation. To date, there are no case reports of acute appendicitis in which the only sign for retroperitoneal perforation is the presence of retroperitoneal air as detected by computed tomography (CT). In the case presented, an 18-year-old male presented to the emergency department with clinical symptoms of acute appendicitis. CT exam demonstrated an inflamed appendix with multiple collections of air in the retroperitoneum, without abscess. Laparotomy revealed perforation of a retrocecal appendix into the retroperitoneum.

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