Slovenská chirurgia 3-4e/2024
Acute appendicitis presenting as epigastric pain due to intestinal malrotation
Acute appendicitis is one of the most common causes of acute abdominal pain. Clinical signs, blood tests, and imaging are important to confirm the diagnosis. Typically, it is presents with periumbilical abdominal pain that migrates to the right lower quadrant, accompanied by guarding, tenderness, and rebound tenderness in the affected area. We report the case of a 74-year-old male with a one-day history of supraumbilical pain. An abdominal computed tomography (CT) scan revealed intestinal malrotation, with the cecum located in a midline supraumbilical position, and CT features indicative of acute appendicitis. This case underscores that the location of pain in acute appendicitis can vary based on the anatomical position of the appendix. CT imaging remains the gold standard for diagnosing appendicitis, especially in atypical presentations. Surgical intervention is the definitive treatment for acute appendicitis.
Keywords: appendicitis, acute appendicitis, intestinal malrotation, case report
