Fig. 15. Intra-abdominal abscess around appendix mimicking perforated appendicitis in a 28-year-old male patient with Crohn’s disease. (A, B) Postcontrast-enhanced coronal computed tomography images show intra-abdominal abscess (white arrows) and segmental mural hyperenhancement of the right colon (white arrowhead) and distal ileum (black arrowhead), suggesting severe active inflammation of Crohn’s disease and penetrating disease. During the initial presentation, the patient was misdiagnosed with acute appendicitis and periappendiceal abscess with secondary bowel change. However, the patient had persistent abdominal pain and anemia after the appendectomy. After the computed tomography image was reviewed again, the patient was diagnosed with active Crohn’s disease involvement with penetrating disease. (C) The patient underwent percutaneous drainage due to recurred abscess. Tubography shows fistula formation (black arrows) between the complicated fluid collection and terminal ileum.
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