A rare case of perforated "sub-hepatic appendicitis" - a challenging differential diagnosis of acute abdomen based on the combination of appendicitis and maldescent of the caecum

Pathol Res Pract. 2017 Jan;213(1):75-78. doi: 10.1016/j.prp.2016.11.006. Epub 2016 Nov 21.

Abstract

Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume. In conclusion, surgeons should be aware of this possibility in the diagnostic and therapeutic management of acute abdomen.

Keywords: Acute appendicitis; Maldescent of caecum; Subhepatic appendicitis.

Publication types

  • Case Reports

MeSH terms

  • Abdomen, Acute / diagnosis*
  • Abdomen, Acute / pathology
  • Abdomen, Acute / surgery
  • Adult
  • Appendicitis / diagnosis*
  • Appendicitis / pathology
  • Appendicitis / surgery
  • Cecum / pathology*
  • Cecum / surgery
  • Diagnosis, Differential
  • Humans
  • Male
  • Peritonitis / diagnosis*
  • Peritonitis / pathology
  • Peritonitis / surgery
  • Treatment Outcome