Open AccessEctopic Perforated Appendicitis in Supraumbilical Region in a Case of Incomplete Intestinal Rotation
Author(s) -
Bhimarao Bhimarao,
Rashmi M. Nagaraju,
Lingaraj B. Patil
Publication year - 2021
Publication title -
journal of evolution of medical and dental sciences
Language(s) - English
Resource type - Journals
eISSN - 2278-4802
pISSN - 2278-4748
DOI - 10.14260/jemds/2021/516
Subject(s) - medicine , appendix , appendicitis , laparotomy , abdomen , perforation , abdominal pain , surgery , cecum , acute abdomen , presentation (obstetrics) , acute appendicitis , radiology , general surgery , paleontology , materials science , metallurgy , punching , biology
Acute appendicitis is one of the most common causes of acute abdominal pain and the most common condition requiring emergency surgery. Intestinal malrotation is a relatively uncommon condition. Depending upon the location of the cecum and appendix, patients with acute appendicitis in intestinal malrotation present atypically with abdominal pain localized on the site of appendicitis. Due to atypical presentation of central abdominal pain, other differentials presenting in this region should be excluded and accurate diagnosis should be made. We present a patient who came with central abdominal pain with elevated markers of inflammation. Contrast enhanced CT of abdomen in this patient revealed ectopic appendicitis located in supraumbilical region with signs of incomplete rotation of the bowel. CT played a pivotal role in identifying the underlying rotational abnormality of bowel, in localizing the inflamed appendix, identifying complications (perforation) and excluding other possible intra-abdominal pathologies. It was also helpful in surgical planning. Emergency laparotomy with appendectomy and lavage were performed on this patient who subsequently recovered.