Subhepatic appendicitis presenting with right upper quadrant pain

Kirresh, Othman; Nikolopoulos, Ioannis; Oke, Tayo; Koshy, Susan

doi:10.12968/hmed.2012.73.10.593

Cited by 5 publications

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“…King in 1955 reported one of the early cases of subhepatic appendicitis . The diagnosis is usually missed preoperatively as it mimics acute cholecystitis and the presence of faecolith could be mistaken for gallstones on US abdomen, as in our patient .…”

mentioning

confidence: 66%

“…Subhepatic appendicitis can mimic other acute surgical abdominal conditions and can lead to a diagnostic dilemma. As surgery is the treatment of choice for appendicitis, establishing a proper diagnosis is of paramount importance especially to avoid dreadful complications like appendicular abscess, rupture and faecal peritonitis . This case illustrates the difficulty encountered in trying to diagnose acute appendicitis in patients whose appendix is mal‐located during foetal development.…”

mentioning

confidence: 96%

“…As surgery is the treatment of choice for appendicitis, establishing a proper diagnosis is of paramount importance especially to avoid dreadful complications like appendicular abscess, rupture and faecal peritonitis. 1,2 This case illustrates the difficulty encountered in trying to diagnose acute appendicitis in patients whose appendix is mal-located during foetal development. We present this case of obstructive appendicitis, where in the diagnosis was established by radiological investigations and managed successfully.…”

mentioning

confidence: 96%

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Subhepatic appendicitis masquerading as acute cholecystitis: a lesson learnt!

Rodrigues

Aswad

2015

ANZ Journal of Surgery

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confidence: 66%

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confidence: 96%

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confidence: 96%

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Subhepatic appendicitis masquerading as acute cholecystitis: a lesson learnt!

Rodrigues

Aswad

2015

ANZ Journal of Surgery

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“…Since then, only a few isolated cases have been described in the literature. Subhepatic appendicitis may present with right upper abdominal pain often mimicking cholecystitis, liver abscess, pyelonephritis, or lumbar pain [3][4][5]. There have been reports of the appendix found in the subhepatic space as an inflamed appendix or as a mass during a laparoscopic / open cholecystectomy [4,6].…”

Section: Discussionmentioning

confidence: 99%

Appendicitis – Is a Clinical Diagnosis Enough?

2023

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Appendicitis has always been considered a clinical diagnosis wherein the surgeon’s clinical acumen and laboratory investigations take priority over the radiological imaging. However, an atypical presentation of appendicitis can occur due to the varying location of the appendix which may result in delayed diagnosis and complications. In such cases radiological imaging such as contrast enhanced computerized tomography helps in the diagnosis. We report two cases of subhepatic appendicitis with different clinical findings.

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“…However, there are various atypical positions of the appendix, including retrocecal (65.3%), pelvic (31%), subcecal (2.3%), pre-ileal (1%), and post-ileal (0.4%) [3]. While right lower quadrant pain is the most common presentation of appendicitis, it is possible for appendicitis to present with right upper quadrant pain or dull abdominal pain in rare cases due to variations in anatomical structure or the location of the appendix, such as a retrocecal appendix [3][4][5][6][7]. Retrocecal appendicitis presenting with right upper abdominal pain may be clinically indistinguishable from other pathologies in the gallbladder, liver, biliary tree, right kidney, and right urinary tract [8].…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Chronic Appendicitis in the Right Upper Quadrant: A Case Report

Chao¹,

Lin²,

Wang³

2023

Cureus

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Chronic appendicitis is a rare cause of chronic abdominal pain that can be difficult to diagnose. We present a patient with chronic right upper quadrant pain that was finally diagnosed as chronic appendicitis. This 71-year-old male had no systemic diseases and presented to our outpatient clinic with right upper quadrant pain for one month. The pain tended to worsen in the early morning but could be relieved by bowel movements, sitting up, or walking. The findings of a physical examination, laboratory data, and abdominal ultrasound were not significant. Upper endoscopy revealed a shallow gastric ulcer at the antrum. However, the abdominal pain was not relieved by esomeprazole. A computed tomography (CT) scan revealed a dilated appendix with some appendicoliths in the retrocecal region. Due to chronic appendicitis, the patient underwent laparoscopic appendectomy, and the histopathological examination of the removed appendix confirmed the diagnosis. The abdominal pain completely resolved after the surgery. Chronic appendicitis should be kept in mind in patients with chronic abdominal pain without a definite diagnosis. This case illustrates that in addition to right lower quadrant pain, chronic appendicitis can also present with right upper quadrant pain or vague abdominal pain. A CT scan is invaluable in the diagnosis of abdominal pain when medical treatment fails to yield improvement.

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Subhepatic appendicitis presenting with right upper quadrant pain

Cited by 5 publications

References 0 publications

Subhepatic appendicitis masquerading as acute cholecystitis: a lesson learnt!

Subhepatic appendicitis masquerading as acute cholecystitis: a lesson learnt!

Appendicitis – Is a Clinical Diagnosis Enough?

A Rare Presentation of Chronic Appendicitis in the Right Upper Quadrant: A Case Report

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