MRI diagnosis of concurrent perforated appendicitis and acute calculous cholecystitis in late pregnancy: a case report
5 affiliations
- 1Radiology Department, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- 2Radiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- 3Radiology Department, University of Health Sciences-Viet Nam National University, Ho Chi Minh City, Vietnam
- 4Vinh Long Government Health Department, Vinh Long, Vietnam
- 5Obstetrics and Gynecology Department, Vinh Long General Hospital, Vinh Long, Vietnam
Abstract
BackgroundAcute appendicitis in pregnancy often presents atypically, and diagnostic delay increases the risk of perforation. Concomitant biliary pathology can further obscure the clinical picture, particularly in late gestation.CaseA 19-year-old woman at 35 weeks’ gestation presented with 1 day of dull right lower quadrant pain with associated right upper quadrant discomfort. Laboratory testing showed leukocytosis (WBC 16.34 K/μL; neutrophils 82.8%) and a markedly elevated hs-CRP (239.21 mg/L). Ultrasound demonstrated an impacted gallbladder neck stone, but the appendix was not visualized. MRI identified an enlarged appendix (14 mm) with periappendiceal inflammation and moderate free fluid consistent with perforated appendicitis with peritonitis, and concurrently demonstrated imaging features of acute calculous cholecystitis with mild bile duct dilatation. Emergency laparoscopy confirmed a necrotic, leaking appendix with localized purulent peritonitis, and laparoscopic appendectomy was performed. Recovery was uncomplicated, and the pregnancy progressed to an uncomplicated vaginal delivery at 38 weeks’ gestation of a healthy newborn.ConclusionIn late pregnancy, overlapping right-sided abdominal pain may reflect concurrent surgical pathology. MRI can rapidly clarify diagnosis and guide timely operative management to reduce maternal-fetal risk.
Related
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BibTeX
@article{huynh2026diagnosis,
title = {{MRI diagnosis of concurrent perforated appendicitis and acute calculous cholecystitis in late pregnancy: a case report}},
author = {Quang Huy Huynh and Quang Huy Huynh and Quang Huy Huynh and Minh Kha Tong Thi and Xuan Quynh Nguyen and Thu Hang Ho Thi and Thu Hang Ho Thi and Chi Phong Nguyen},
journal = {British Journal of Biomedical Science},
year = {2026},
month = oct,
doi = {10.3389/bjbs.2026.16647},
url = {https://doi.org/10.3389/bjbs.2026.16647},
note = {CC BY},
}
RIS
TY - JOUR
TI - MRI diagnosis of concurrent perforated appendicitis and acute calculous cholecystitis in late pregnancy: a case report
AU - Quang Huy Huynh
AU - Quang Huy Huynh
AU - Quang Huy Huynh
AU - Minh Kha Tong Thi
AU - Xuan Quynh Nguyen
AU - Thu Hang Ho Thi
AU - Thu Hang Ho Thi
AU - Chi Phong Nguyen
PY - 2026
DA - 2026/10/26
JO - British Journal of Biomedical Science
DO - 10.3389/bjbs.2026.16647
UR - https://doi.org/10.3389/bjbs.2026.16647
AB - BackgroundAcute appendicitis in pregnancy often presents atypically, and diagnostic delay increases the risk of perforation. Concomitant biliary pathology can further obscure the clinical picture, particularly in late gestation.CaseA 19-year-old woman at 35 weeks’ gestation presented with 1 day of dull right lower quadrant pain with associated right upper quadrant discomfort. Laboratory testing showed leukocytosis (WBC 16.34 K/μL; neutrophils 82.8%) and a markedly elevated hs-CRP (239.21 mg/L). Ultrasound demonstrated an impacted gallbladder neck stone, but the appendix was not visualized. MRI identified an enlarged appendix (14 mm) with periappendiceal inflammation and moderate free fluid consistent with perforated appendicitis with peritonitis, and concurrently demonstrated imaging features of acute calculous cholecystitis with mild bile duct dilatation. Emergency laparoscopy confirmed a necrotic, leaking appendix with localized purulent peritonitis, and laparoscopic appendectomy was performed. Recovery was uncomplicated, and the pregnancy progressed to an uncomplicated vaginal delivery at 38 weeks’ gestation of a healthy newborn.ConclusionIn late pregnancy, overlapping right-sided abdominal pain may reflect concurrent surgical pathology. MRI can rapidly clarify diagnosis and guide timely operative management to reduce maternal-fetal risk.
SN - 2474-0896
ER -