Subhepatic appendix: an ectopic topography not to be disregarded: a case report

Area of Science:

• Gastroenterology
• Surgical Pathology
• Embryology

Background:

• Subhepatic appendix is frequently caused by intestinal rotation anomalies during embryogenesis.
• This ectopic location, especially in older adults, complicates appendicitis diagnosis.
• It can mimic other conditions, leading to delayed or incorrect diagnoses.

Observation:

• A 60-year-old male presented with right upper quadrant abdominal pain, progressing to generalized peritonitis.
• Initial diagnosis was unclear, necessitating surgical exploration.
• A perforated subhepatic appendix was discovered during surgery.

Findings:

• The patient underwent successful surgery for a perforated subhepatic appendix.
• No postoperative complications were observed.
• The patient was discharged eight days after the operation.

Implications:

• Subhepatic appendicular peritonitis in the elderly poses significant diagnostic difficulties.
• Considering acute ectopic appendicitis in cases of right upper quadrant pain is vital.
• Prompt diagnosis and treatment can mitigate severe complications associated with this condition.