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Case Reports in Surgery
Volume 2016, Article ID 6067374, 3 pages
Case Report

Malrotated Subhepatic Caecum with Subhepatic Appendicitis: Diagnosis and Management

1Department of Surgery, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
2Department of Surgery, Hospital Keningau, Sabah, Malaysia
3Department of Radiology, Hospital Keningau, Sabah, Malaysia

Received 1 July 2016; Accepted 7 August 2016

Academic Editor: Boris Kirshtein

Copyright © 2016 Hock Chin Chong et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix. Our discussion focuses on the diagnostic approach and clinical and surgical management. We hope that our report will increase the awareness among the clinicians and hasten the management of such rare condition to avoid complications.