title: Malrotated Subhepatic Caecum with Subhepatic Appendicitis: Diagnosis and Management.
abstract: Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix. Our discussion focuses on the diagnostic approach and clinical and surgical management. We hope that our report will increase the awareness among the clinicians and hasten the management of such rare condition to avoid complications.
authors.affiliation: Department of Surgery, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia.
authors.forename: Hock Chin
authors.initials: HC
authors.lastname: Chong
authors.affiliation: Department of Surgery, Hospital Keningau, Sabah, Malaysia.
authors.forename: Feng Yih
authors.identifier: 0000-0001-9686-8258
authors.initials: FY
authors.lastname: Chai
authors.affiliation: Department of Radiology, Hospital Keningau, Sabah, Malaysia.
authors.forename: Dhayal
authors.initials: D
authors.lastname: Balakrishnan
authors.affiliation: Department of Surgery, Hospital Keningau, Sabah, Malaysia.
authors.forename: Siti Mohd Desa
authors.initials: SM
authors.lastname: Asilah
authors.affiliation: Department of Surgery, Hospital Keningau, Sabah, Malaysia.
authors.forename: Irene Nur Ibrahim
authors.initials: IN
authors.lastname: Adila
authors.affiliation: Department of Surgery, Hospital Keningau, Sabah, Malaysia.
authors.forename: Khuzaimah Zahid
authors.initials: KZ
authors.lastname: Syibrah