Right lower quadrant ultrasound in a 6-year-old male with perforated appendicitis

This 6-year-old male presented with right lower quadrant abdominal pain. Targeted ultrasound demonstrates a thickened appendix (arrow), with an ill-defined wall and complex periappendiceal fluid collection (*), and an adjacent thickened bowel loop (arrowhead). Findings are consistent with a perforated appendicitis.