Man 35yo, onset epigastric pain treated as gastritis for one week, fever.
Ultrasound of abdomen= pain at upper left abdomen quadrant (US 1 probe put over pain point).
US 2= mass rounding as an abscess, CDI: no more vascular supply.
US 3 (with linear probe) intra abscess the linear structure look like appendix).
US 4 = cross section.
Emergency CT with CE= mass wall-off by small intestine and great omentum as an abscess ( CT1, CT2).
Blood test WBS = high 14k , with neutro 9.9, CRP 38.3ng/dl.
Preoperative diagnostic is intra abdomen abscess due to ectopic appendicitis.
Laparoscopic view = the pus goes out from this mass and open operation removed appendiceal partial necrosis and mobile coecum.
Conclusion= appendiceal abscess in ectopic position at left abdomen site.