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Related Concept Videos

Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Appendicitis-II: Diagnostic Studies and Management01:29

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Frustration and Conflict: Approach-Approach, Approach-Avoidance01:20

Frustration and Conflict: Approach-Approach, Approach-Avoidance

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Frustration occurs when people are obstructed or prevented from achieving a desired goal or fulfilling a perceived need. For example, when someone's input is ignored in a discussion, it can lead to feelings of frustration. Conflict, however, arises from opposing interests, goals, or actions. Conflicts can take various forms based on the nature of these opposing desires or goals.
One common type of conflict is the Approach–Approach Conflict. In this case, a person faces two desirable...
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Related Experiment Video

Updated: Feb 14, 2026

Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
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Is the laparoscopic approach appropriate for pediatric subhepatic appendicitis?

Belén Aneiros Castro1, Indalecio Cano Novillo1, Araceli García Vázquez1

  • 1Department of Pediatric Surgery, 12 October Hospital, Madrid, Spain.

Asian Journal of Endoscopic Surgery
|February 20, 2018
PubMed
Summary

Laparoscopic surgery for subhepatic appendicitis in children is safe, with similar complication rates to non-subhepatic cases. However, this unusual appendix location presents higher rates of complicated appendicitis and technical challenges.

Keywords:
Childrenlaparoscopysubhepatic appendicitis

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Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes
  • Gastrointestinal Surgery

Background:

  • Subhepatic appendicitis is a rare pediatric condition posing surgical challenges.
  • Laparoscopic appendectomy is a common procedure for appendicitis.

Purpose of the Study:

  • To compare outcomes of laparoscopic appendectomies based on appendix location.
  • To evaluate the safety and feasibility of laparoscopic subhepatic appendectomy in children.

Main Methods:

  • Retrospective review of 1736 pediatric laparoscopic appendectomies.
  • Comparison between subhepatic (n=56) and non-subhepatic (n=1680) appendix locations.
  • Statistical analysis with P < 0.05 considered significant.

Main Results:

  • Subhepatic appendicitis cases showed higher rates of gangrenous (44.6%) or perforated (16.1%) disease compared to non-subhepatic (phlegmonous 56.9%).
  • The subhepatic group experienced more technical difficulties (1.6%), required abdominal drains (18.6%), and had longer operative times and hospital stays.
  • Intraoperative and postoperative complication rates were comparable between the two groups.

Conclusions:

  • Laparoscopic subhepatic appendectomy is a safe procedure in children, not associated with increased complications.
  • The atypical subhepatic location increases the likelihood of complicated appendicitis and presents technical challenges during surgery.