A rare case: Retrocecal appendicitis adherent to the liver capsule

Abstract

The cases of appendicitis take an important place in the hospital emergency departments and it must be kept in mind in the differential diagnosis of patients presenting with abdominal pain. Related to cecum, the appendix can be found in many different positions; however, it is mostly observed descending intraperitoneally (31-74%) and at the retrocecal region (26-65%). In this case report, we present the case of a 26-year-old female patient admitted to the emergency room with a colic pain in the right upper quadrant for about 2 days. Computed tomography revealed contamination in the fatty plans around the cecum and adhesive retrocecal appendicitis from the liver to the retroperitoneum. Appendectomy was performed. The pathology result was gangrenous appendicitis. In the literature, there is no similar case of appendicitis with hepatic adhesions. In conclusion, we want to emphasize that physicians and surgeons in the emergency departments must be more careful during the differential diagnosis of a patient with appendicitis and atypical symptoms and a more detailed investigation is required.

Keywords: Appendicitis; liver capsule; retrocecal appendix.

Figure 1

There is contamination in the fatty plans around the cecum

Figure 2

Appendix tissue extension into the liver

Figure 3

The phlegmonous end portion of the appendix tissue