Pediatric subhepatic appendicitis with elevated lipase

Rare appendiceal escapades in childhood: the Grande experience!

“…The appendix is commonly located in the retrocecal position in 65% cases and less commonly in the pelvis, subcecal, pre- and post-ileal locations in the decreasing order of frequency. Rarer positions include sub-hepatic, lateral pouch, mesocoeliac, left-sided and intraherniary, with reported incidence of SHA being 0.08% [ 16 ]. This was first reported by King in 1955 [ 15 , 17 ].…”

Subhepatic Appendicitis in an 11-year-old Boy: A Case Report

“…Subhepatic appendicitis is a rare disease and accounts for 0.08% of all cases of appendicitis with a marginally higher incidence of 1% and 3.2% [3,5,8] in other studies. Although the majority of reports mentioned in the literature discuss the incidence of subhepatic appendicitis in adults, only a few cases have been reported in the pediatric age group [2,3,[8][9][10][11].…”

“…While an ultrasound scan of the abdomen is the first radiological investigation, it has a high probability of misdiagnosis [12]. Nevertheless, a CT scan is the best modality to identify subhepatic appendicitis [2] as it is reported to have high sensitivity (100%), specificity (95%) and accuracy (98%) in establishing the diagnosis of acute appendicitis [13].…”

“…Appendicitis taking place in the subhepatic space (i.e., subhepatic appendicitis) is largely not common, and it occurs as a result of intestinal malrotation and/or non-decent of the cecum during embryonic development [2]. Owing to its unusual site, subhepatic appendicitis presents a substantial challenge in its diagnosis and management as it can mimic upper abdominal conditions [2].…”

Neglected Appendicitis? One Patient Two Diagnosis? Differential Diagnosis of Acute Abdominal Pain

“…To our knowledge this is the first reported case in adults of elevated amylase and lipase this high in a patient with appendicitis and a radiographically and intra-operative normal pancreas. [1][2][3][4][5][6][7][8][9][10][11] This leaves us to think if the acute pancreatitis was treated with conservative management and appendicitis a new diagnosis? Appendicitis was only diagnosed on 6 th day based on migration of the pain and CT results.…”