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

• Main Authors: Abdoul Kadir Ibrahim Mamadou, Souleymane Mounkaila, Nouhou Hama Aghali, Mahaman Laouali Harouna Amadou, Ousseini Adakal
• Format: Article
• Language: English
• Published: BMC 2021-05-01
• Series: Journal of Medical Case Reports
• Subjects: Peritonitis; Subhepatic appendix; Embryogenesis; Case report
• Online Access: https://doi.org/10.1186/s13256-021-02883-6

Abstract Introduction Subhepatic appendix is most often due to an anomaly of rotation of the primary intestine occurring during embryogenesis. This ectopic topography associated with advanced age can be a serious diagnosis problem at the stage of appendicitis or appendicular peritonitis. Case presentation We report the case of a 60-year-old melanoderm man, with a history of urinary pathology and peptic ulcer, referred from a health district for abdominal pain of the right hypochondrium evolving for about 5 days, secondarily generalized, in whom we suspected peritonitis, the etiology of which remains to be determined. During the surgical intervention, after preoperative resuscitations measures, a phlegmonous perforated appendix was found under the liver. No postoperative complication was noted, and he was discharged home 8 days after his operation. Conclusion Subhepatic appendicular peritonitis occurring in an elderly patient poses enormous diagnostic problems. When faced with right upper quadrant pain, considering acute ectopic appendicitis would significantly reduce complications.