Published: 2021-10-28

Sub hepatic acute appendicitis: a challenging case to diagnose and successfully managed by laparoscopic procedure

Pranay Palle, Krishna Ramavath, Nyna Sindhu, Tushar Parmeshwar, Sunil B. Boya Tailor, Venu B. Malpuri


Sub hepatic acute appendicitis is a rare condition to occur. It can present as right upper quadrant pain and makes challenging in diagnosis and early management. Sub hepatic appendix normally due to malrotation of intestine during developmental period. This condition can mimic as acute cholecystitis, liver abscess. We are presenting a case of sub hepatic acute appendicitis and successfully managed by laparoscopic appendectomy. Sub hepatic acute appendicitis is challenging case to diagnosis and early management. Because late in diagnosis can cause to perforation of appendix and its complications.


Appendix, Sub hepatic appendicitis, Laparoscopy appendectomy, CECT, Cecum, right upper quadrant

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Rappaport W, Warneke J. Subhepatic appendicitis. Am Fam Physician. 1989;39(6):146-8.

Palanivelu C, Rangarajan M, John S. Laparoscopic appendectomy for appendicitis in uncommon situations: the advantages of a tailored approach. Singapore Med J. 2007;48:737-40.

Patel R, Lakshman S, Hays T, Thomas E. Sub hepatic appendix with fecolith mimicking acute cholecystitis with gall stone. J Clin Ultrasound. 1996;24:45-7.

King A. Sub hepatic appendicitis. AMA Arch Surg. 1955;71(2):265-7.

Ball W, Privitera A. Sub hepatic appendicitis: a diagnostic dilemma. BMJ Case Rep. 2013;2013:bcr2013009454.

Chalazonitis A, Tzovara I, Sammouti E, Ptohis N. CT in appendicitis. Diagn Interv Radiol. 2008;14:19-25.

Schumpelick V, Dreuw B, Ophoff K. Appendix and cecum. Embryology, anatomy, and surgical applications. Surg Clin North Am. 2000;80:295-318.

Ates M, Sevil S, Bulbul M. Routine use of laparoscopy in patients with clinically doubtful diagnosis of appendicitis. Journal of laparoendoscopic &Advanced Surgical Techniques. 2008;18(2):189-93.