title: 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.
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.
authors.affiliation: Dept. of General, Abdominal and Vascular Surgery, University Hospital of Magdeburg, Germany. Electronic address: Costanza.Chiapponi@uk-koeln.de.
authors.forename: Costanza
authors.initials: C
authors.lastname: Chiapponi
authors.affiliation: Dept. of General, Abdominal and Vascular Surgery, University Hospital of Magdeburg, Germany.
authors.forename: Olof
authors.initials: O
authors.lastname: Jannasch
authors.affiliation: Dept. of General, Abdominal and Vascular Surgery, University Hospital of Magdeburg, Germany.
authors.forename: Manuela
authors.initials: M
authors.lastname: Petersen
authors.affiliation: Institute of Pathology, University Hospital, Magdeburg, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Lessel
authors.affiliation: Dept. of General, Abdominal and Vascular Surgery, University Hospital of Magdeburg, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Bruns
authors.affiliation: Dept. of General, Abdominal and Vascular Surgery, University Hospital of Magdeburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Meyer
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002432:Cecum / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
keywords: Acute appendicitis; Maldescent of caecum; Subhepatic appendicitis