Chong Hock Chin, Chai Feng Yih, Balakrishnan Dhayal, Asilah Siti Mohd Desa, Adila Irene Nur Ibrahim, Syibrah Khuzaimah Zahid
Department of Surgery, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia.
Department of Surgery, Hospital Keningau, Sabah, Malaysia.
Case Rep Surg. 2016;2016:6067374. doi: 10.1155/2016/6067374. Epub 2016 Aug 25.
Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix. Our discussion focuses on the diagnostic approach and clinical and surgical management. We hope that our report will increase the awareness among the clinicians and hasten the management of such rare condition to avoid complications.
肝下盲肠和阑尾是一种非常罕见的情况。它是由于胎儿肠道旋转异常导致肠道旋转和固定不完全而发生的。阑尾炎是一种常见的外科急症,与异常的肝下位置相结合,在其诊断和治疗方面带来了巨大挑战。在此,我们描述一名42岁患有慢性消化不良的男性,他出现败血症以及右季肋区和上腹部严重疼痛。最终诊断为肝下阑尾急性阑尾炎。我们的讨论集中在诊断方法以及临床和外科治疗。我们希望我们的报告能提高临床医生的认识,并加快对这种罕见病症的治疗以避免并发症。