Clinical Presentation

A 28-year-old man presents with fever 10 days after the onset of abdominal pain.

(A) Contrast-enhanced computed tomographic (CT) scan shows a walledoff fluid collection (arrow). (B) Second component of the fluid collection (arrow) and a calcifi cation suspected to be an appendicolith (arrowhead). (C) Coronal reformatting shows infracecal location of the collection (arrow). (D) Image obt ained af ter drain placement.

Differential Diagnosis

• Appendiceal abscess: Is most likely given the probable appendicolith and right lower quadrant fluid component.
  
• Diverticular abscess: May be indistinguishable but more commonly occurs on the left.

Essential Facts