Unusual manifestation of acute retrocecal appendicitis: Pericholecystic fluid

Abstract

Subhepatic-retrocecal appendicitis is a rare entity in which the diagnosis is challenging. In patients presenting with right abdominal pain with atypical clinical, laboratory and ultrasound (US) findings, acute appendicitis should be eliminated with computed tomography (CT). Multi-detector CT (MDCT) can be used effectively for the diagnosis of retrocecal appendicitis without additional preparation or focused examination. Here, we present a patient with acute subhepatic-retrocecal appendicitis in whom the clinical and US findings mimicked acute cholecystitis. To the best of our knowledge, there is no previous report related to acute appendicitis presented only with pericholecystic fluid that could be diagnosed with MDCT. Retrocecal-subhepatic appendicitis is a rare condition that might present with atypical clinical, laboratory and radiological signs. US is usually insufficient for the definitive diagnosis. In this situation, MDCT could be a rapid and efficient tool for localizing the appendix and for the differential diagnosis.