The Great Masquerader

A 44-year-old diabetic man presented with complains of fever for 10 days, pain and swelling on right lower back for 5 days. He gave history of pain abdomen 4 weeks back, which subsided with over the counter pain killers in 2–3 days. Acute appendicitis has varied presentation and is very often considered as a great masquerader since clinical diagnosis becomes difficult in many patients. This case depicts the very unusual anatomical pathway of collection extension following a complicated acute appendicitis.