Presentation
The patient presented with abdominal pain for the past few days.
Patient Data
Abdomen computed tomography shows the cecum in the right lumbar region with the appendix extending from its inner part superiorly, curving between the lower pole of the right kidney and cecum with the tip in Morrison's pouch. Its wall is smooth and thin, showing no signs of thickening, enhancement, or inflammation. The pericolonic fat around the appendix appears normal, without stranding or inflammatory changes. There are no signs of appendicitis, enlarged lymph nodes, abscesses, or free fluid in the abdomen.
Case Discussion
The subhepatic appendix, an anomaly where the appendix fails to descend during embryonic development and remains abnormally high, is exceptionally rare, occurring in only 0.08% of appendicitis cases. This atypical location can mimic gastric or hepatobiliary pathologies due to its proximity to these organs, leading to misleading presentations and delayed diagnosis. Accurately depicting the position of the appendix is crucial for understanding the clinical presentation in case of inflammation.
While typically inflamed appendices manifest in the lower right abdomen, the subhepatic appendix can present with right upper quadrant pain, mimicking conditions like cholecystitis or hepatitis. This case, however, showcases a normal appendix located in the subhepatic position, serving as an example of this relatively rare anatomical variant.
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