Abstract
Amaç: Apendiks vermiformis çekumun posteromedial yüzünden köken alan ve en sık retroçekal alanda lokalize körelmiş bir organdır. Bu olgu sunumunda subhepatik akut apandisit tanısı ile apendektomi yapılan hastayı sunmayı amaçladık.
Olgu: 24 yaşında kadın hasta üç gündür devam eden ve giderek artan sağ üst kadran ağrısı nedeniyle başvurdu. Muayenede sağ üst kadran hassasiyet ve defans mevcuttu. Lökositoz ve C-reaktif protein yüksekliği olan hastanın tomografisinde subhepatik alana uzanan akut apandisit tespit edildi. Laparoskopik apendektomi yapılan hastanın patolojisi flegmonöz akut apandisit ile uyumlu idi.
Sonuç: Subhepatik akut apandisit çok nadir görülen bir klinik tablodur. Olası tanı gecikmelerinin ve komplikasyon gelişiminin önlenmesi için, sağ üst kadran ağrısı olan hastalarda subhepatik akut apandisitten şüphelenilmeli ve abdominopelvik bilgisayarlı tomografiden yararlanılıp zamanında tanı ve tedavi yapılmalıdır.
Keywords
References
- Kantar S. Nadir bir akut karın nedeni: appendiks vermiformis divertiküliti olgu sunumu. Pam Med J. 2021;14(2):494-5.
- Nayak BS. Why the tip of vermiform appendix has variable position? Med Hypotheses. 2010;75(6):682-3.
- Ghorbani A, Forouzesh M, Kazemifar AM. Variation in anatomical position of vermiform appendix among iranian population: an old issue which has not lost its importance. Anat Res Int. 2014;2014: 313575.
- Kim S, Lim HK, Lee JY, Lee J, Kim MJ, Lee AS. Ascending retrocecal appendicitis: clinical and computed tomographic findings. J Comput Assist Tomogr. 2006;30(5):772-6.
- Buluş H, Coşkun A. Subhepatik apandisit. Kolon ve Rektum Hastalıkları Dergisi. 2010;20(1):29-32.
- Alqahtani SM, Lasheen M, Paray S. Subhepatic Appendicitis in an 11-year-old Boy: A Case Report. Cureus. 2019;11(12):e6489.
- Palanivelu C, Rangarajan M, John S, Senthilkumar R, Madhankumar M. Laparoscopic appendectomy for appendicitis in uncommon situations: the advantages of a tailored approach. Singapore Med J. 2007;48(8):737.
- Ball WR, Privitera A. Subhepatic appendicitis: a diagnostic dilemma. Case Reports. 2013;2013:bcr2013009454.
- Singh S, Jha AK, Sharma N, Mishra TS. A case of right upper abdominal pain misdiagnosed on computerized tomography. Malays J Med Sci. 2014;21(4):66-8.
- McAninch SA, Essenburg A. Pediatric subhepatic appendicitis with elevated lipase. Am J Emerg Med. 2019;37(1):174.e1-.e3.
Abstract
Aim: The vermiform appendix is a vestigial organ originating from the posteromedial side of the caecum and most commonly localized in the retrocaecal area. In this case report, we aimed to present the patient diagnosed with subhepatic acute appendicitis and who underwent appendectomy.
Case: A 24-year-old female was admitted with increasing right upper quadrant pain lasting for three days. On examination, there was right upper quadrant tenderness and defense. The patient's computed tomography detected acute appendicitis extending to the subhepatic area with leucocytosis and elevated C-reactive protein. The pathology of the patient who underwent laparoscopic appendectomy was compatible with phlegmonous acute appendicitis.
Conclusion: Subhepatic acute appendicitis is a very rare clinical picture. To prevent possible delays in diagnosis and development of complications, subhepatic acute appendicitis should be suspected in patients with right upper quadrant pain, and timely diagnosis and treatment should be made using abdominopelvic computed tomography.
Keywords
References
- Kantar S. Nadir bir akut karın nedeni: appendiks vermiformis divertiküliti olgu sunumu. Pam Med J. 2021;14(2):494-5.
- Nayak BS. Why the tip of vermiform appendix has variable position? Med Hypotheses. 2010;75(6):682-3.
- Ghorbani A, Forouzesh M, Kazemifar AM. Variation in anatomical position of vermiform appendix among iranian population: an old issue which has not lost its importance. Anat Res Int. 2014;2014: 313575.
- Kim S, Lim HK, Lee JY, Lee J, Kim MJ, Lee AS. Ascending retrocecal appendicitis: clinical and computed tomographic findings. J Comput Assist Tomogr. 2006;30(5):772-6.
- Buluş H, Coşkun A. Subhepatik apandisit. Kolon ve Rektum Hastalıkları Dergisi. 2010;20(1):29-32.
- Alqahtani SM, Lasheen M, Paray S. Subhepatic Appendicitis in an 11-year-old Boy: A Case Report. Cureus. 2019;11(12):e6489.
- Palanivelu C, Rangarajan M, John S, Senthilkumar R, Madhankumar M. Laparoscopic appendectomy for appendicitis in uncommon situations: the advantages of a tailored approach. Singapore Med J. 2007;48(8):737.
- Ball WR, Privitera A. Subhepatic appendicitis: a diagnostic dilemma. Case Reports. 2013;2013:bcr2013009454.
- Singh S, Jha AK, Sharma N, Mishra TS. A case of right upper abdominal pain misdiagnosed on computerized tomography. Malays J Med Sci. 2014;21(4):66-8.
- McAninch SA, Essenburg A. Pediatric subhepatic appendicitis with elevated lipase. Am J Emerg Med. 2019;37(1):174.e1-.e3.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 30, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 4 |
