Subhepatic Perforated Appendicitis Complicated by Intestinal Obstruction: A Case Report
Keywords:
Subhepatic appendicitis, Perforated appendix, Intestinal obstruction, Exploratory LaparotomyAbstract
Subhepatic appendicitis is an anatomical variant of acute appendicitis that sometimes occurs secondary to midgut malrotation or developmental abnormalities during fetal development. It represents only 0.01% of cases of appendicitis and can be misdiagnosed for other intra-abdominal conditions like acute cholecystitis or liver abscesses, resulting in delayed diagnosis. This is a case of a 30-year-old patient with subhepatic perforated appendicitis complicated by intestinal obstruction. The patient was taken for emergency exploratory laparotomy after thorough investigations and clinical examination. Subhepatic appendicitis was found intraoperatively. Appendectomy was performed under aseptic techniques. Postoperatively, the patient was stable and tolerating oral fluids. This case highlights the role of imaging and early surgical approach in managing subhepatic appendicitis.
Downloads
Metrics
References
Hakim M, Mostafa R, Al Shehri M, Sharawy S. Surgical management of subhepatic perforated appendicitis: A case report. J Med Case Rep. 2020;14:151. Available from: https://doi.org/10.1186/s13256-020-02499-2
White H, Laykova AS, O'Dowd B, Wasfie T. Unusual presentation of perforated acute appendicitis: A case report. Am J Case Rep. 2022;23:e935405. Available from: https://doi.org/10.12659/AJCR.935405
McGuin C, Pillay Y. An unusual case report of a subhepatic appendix and an interlobar hepatic bridge in a patient with acute cholecystitis. J Surg Case Rep. 2023;2023(4):rjad185. Available from: https://doi.org/10.1093/jscr/rjad185
Afroze M KH, Muralidharan S, Shanmugam A, Khan AW, Bhowmik S. Two cases of positional variation of the cecum and appendix with a vascular anomaly: A diagnostic dilemma. Cureus. 2022;14(7):e27091. Available from: https://doi.org/10.7759/cureus.27091.
Potey K, Kandi A, Jadhav S, Gowda V. Study of outcomes of perforated appendicitis in adults: A prospective cohort study. Ann Med Surg (Lond). 2023;85:694-700. Available from: https://doi.org/10.1097/MS9.0000000000000277
Teferi DA, Gebru S, Kassa AT, Abebe HA, Yehualawork SF, Teferi WA. Acute appendicitis in a patient with sub-hepatic, sub-serosal, and retroperitoneal location: An intraoperative management challenge. Int J Surg Case Rep. 2024;125:110540. Available from: https://doi.org/10.1016/j.ijscr.2024.110540
Ahmed A, Feroz SH, Dominic JL, Muralidharan A, Thirunavukarasu P. Is emergency appendicectomy better than elective appendicectomy for the treatment of appendiceal phlegmon?: A review. Cureus. 2020;12(12):e12045. Available from: https://doi.org/10.7759/cureus.12045
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Waseem Ullah, Faseeh Muhammad, Muhammad Daud, Aahan Atta, Muneeb Ur Rehman, Fazal Ahmad , Bakir Khan

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.