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Unusual manifestation of acute retrocecal appendicitis: pericholecystic fluid

Oktay Algın1, Evrim Özmen, Ayşenur Sirin Özcan

  • 1Department of Radiology, Atatürk Training and Research Hospital, Bilkent, Ankara, Turkey.

Ulusal Travma Ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery : TJTES
|April 17, 2013
PubMed

Insights

Subhepatic-retrocecal appendicitis is a rare condition often misdiagnosed. Multi-detector computed tomography (MDCT) effectively diagnoses this atypical appendicitis, even when ultrasound findings mimic other conditions.

Area of Science:

  • Gastroenterology
  • Radiology
  • Surgical Anatomy

Background:

  • Subhepatic-retrocecal appendicitis presents diagnostic challenges due to its rarity and atypical symptoms.
  • Right abdominal pain with unusual clinical, laboratory, and ultrasound (US) findings necessitates ruling out acute appendicitis.

Observation:

  • A case of acute subhepatic-retrocecal appendicitis is presented, where initial clinical and US findings suggested acute cholecystitis.
  • The patient presented with pericholecystic fluid, a sign not previously reported as the sole indicator for diagnosing appendicitis via MDCT.

Findings:

  • Multi-detector computed tomography (MDCT) is highly effective for diagnosing retrocecal appendicitis without special preparation.
  • MDCT offers a rapid and efficient method for localizing the appendix and aiding differential diagnosis in complex cases.

Implications:

  • MDCT should be considered in patients with atypical right abdominal pain and inconclusive US findings, especially when cholecystitis is suspected.
  • This case highlights the utility of MDCT in identifying rare appendiceal pathologies that can mimic other common surgical emergencies.

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