Acute Appendicitis Presenting As Acute Gastritis in an Adult Patient with Undiagnosed Congenital Gut Malrotation: A Case Report

Unusual presentation of left sided acute appendicitis in elderly male with asymptomatic midgut malrotation

“…Imaging with computed tomography can help not only in pre-operative planning of such cases, but also minimises delay in diagnosis. Sensitivity and specificity of CT in setting of acute appendicitis in patients with midgut rotation has been reported between 90 and 97% and 94–100% respectively [6] . The most typically reported CT-findings in these patients include: right sided DJ flexure, left sided caecal pole, inversion of the SMA/SMV relationship and hypoplasia/aplasia of the pancreatic uncinate process [3] , [7] , [8] , [9] .…”

“…Acute appendicitis with MM has only previously been described in a handful of case report and small case series [1] , [2] , [3] , [5] , [6] , [7] , [8] , [9] , [10] . In a previous report, misdiagnosis as diverticulitis led to delay in definitive management, with the patient subsequently undergoing emergency laparotomy [2] .…”

“…These cohort of patients are also at increased risk of volvulus and intestinal obstruction [11] . In most reported cases, patients underwent laparotomy with attempted correction of the malrotation [1] , [3] , [5] , [6] , [9] . Other reports of laparoscopic appendectomy have also been documented [6] .…”

“…In most reported cases, patients underwent laparotomy with attempted correction of the malrotation [1] , [3] , [5] , [6] , [9] . Other reports of laparoscopic appendectomy have also been documented [6] . Laparoscopy is useful not only in establishing differential diagnosis but for definitive surgery.…”

Appendicitis with appendicular atresia: a rare presentation

“…appendicular agenesis has a reported incidence of 1 in 100,000 cases [ 12 – 14 ]. Others include horse-shoe appendix [ 15 ], malrotation [ 16 ], and a single reported case of triplication of appendix. As per our knowledge, the case that we have hereby reported is only the fourth case of appendicular atresia.…”