Trung Nguyen1 and Ashwini Kumar2*
1University of the Incarnate Word School of Osteopathic Medicine, San Antonio, Texas, USA 2Methodist Healthcare System of San Antonio Ltd, Laparoscopic and Bariatric Surgery, San Antonio, Texas, USAFulltext PDF
Appendicitis has variable presentations due to the inconsistent appendiceal location. The most common location is arguably retrocecal with others being pelvic, subcecal, and pre- and post-ileal. The retrocecal location may extend periduodenally causing confusion as it can be mistaken for duodenitis. We present a case of a 35-year-old female who presented with Right Upper Quadrant (RUQ) and bilateral flank pain. Initial workup included a RUQ ultrasound, which was negative for gallbladder wall thickening. The diagnosis of true duodenitis secondary to appendicitis at the porta hepatis adjacent to the descending duodenum was established with computed tomography. The patient underwent a laparoscopic appendectomy and her inflammation resolved post-procedurally with antibiotics. She was discharged on post-operative day two.
Appendicitis; Retroperitoneal appendix; Retrocecal; Pelvic
Nguyen T, Kumar A. Duodenitis Secondary to Appendicitis and Appendiceal Location: A Case Report. Ann Surg Case Rep. 2020; 3(3): 1034..