Findings
There is a gas containing mass in the RLQ compatible with abscess.
Discussion
This patient is four months s/p appendectomy in Cape Verde. The likely differential in this patient is an abscess secondary to a blowout of the appendiceal stump or an abscess due to retained surgical material. At surgery, this RLQ abscess was found to contain a retained surgical sponge. The sponge did not contain the usual radiopaque marker – possibly because it was from Cape Verde.


http://eradiology.bidmc.harvard.edu/Classics/item.aspx?section=Emergency+Radiology&labelpk=33f0adab-853f-4010-a0e2-0756b3f1eac5&pk=86d9d644-87ce-4836-a080-bb12f09c6375

Appendiceal abscess drainage. A. A 19-year-old who presented with fevers and right lower quadrant pain. CT scan shows an appendiceal abscess (arrows). B. Following ultrasound guided needle placement, a guidewire is coiled in the cavity under fluoroscopy. C. An 8-Fr drain is placed under fluoroscopic guidance and the abscess is drained. D. Follow-up CT scan after catheter removal shows complete resolution of the abscess.

http://imaging.consult.com/image/chapter/Gastrointes...

http://www.radrounds.com/.../listTagged?tag=abscess

abdominal black arrow=apendicolith.

p=psoas.

c=cecum.

open arrow=ureter.

p=psoas muscle.