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      An unusual case report of a subhepatic appendix and an interlobar hepatic bridge in a patient with acute cholecystitis

      case-report
      Author(s): ,
      Publication date (Electronic):
      Journal: Journal of Surgical Case Reports
      Publisher: Oxford University Press
      Keywords: Subhepatic appendix, Interlobar bridge, Hepatic bridge

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          Abstract

          A subhepatic appendix and an interlobar hepatic bridge are both rare anatomical variants. To find both entities in the same patient at the time of a laparoscopic cholecystectomy makes for a unique case report. Subhepatic appendicitis has a reported incidence of 0.08%, and there have been only published three case reports of an interlobar hepatic bridge. Their lack of involvement in acute cholecystitis facilitated an easier dissection process and prevented serious complications to the liver or the right hemi-colon.

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          Most cited references11

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          Laparoscopic appendectomy for appendicitis in uncommon situations: the advantages of a tailored approach.

          C Palanivelu, M. Rangarajan, R. Senthilkumar … (2007)
          Appendicitis in unusual locations or situations always poses a diagnostic dilemma and surgery is never straightforward. We aim to highlight the advantages of laparoscopy, including our own modifications, in some unusual presentations of appendicitis. We treated a total of 7,210 patients with appendicitis over 14 years from 1992 to 2006. In this study, we included patients with subhepatic appendicitis (0.08 percent), appendectomy in midgut malrotation (0.09 percent), appendicitis in situs inversus totalis (0.01 percent) and appendicitis in the lateral pouch position (0.01 percent). All patients underwent laparoscopic appendectomy. Patients with subhepatic appendicitis, appendicitis in situs inversus and appendicitis in the lateral pouch position had an uneventful postoperative course. For the patients who underwent appendectomy as part of the treatment for malrotation and the patient with the perforated subhepatic appendix, hospital stay was slightly prolonged. Most patients in our study did not have a confirmed preoperative diagnosis. Diagnostic laparoscopy through the umbilical port helped confirm the diagnosis. Port positions were then planned according to the exact position of the appendix and the technique was modified to suit each individual patient. In the surgical scenarios described here, laparoscopy is invaluable in both diagnosis and treatment.
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            Subhepatic appendicitis.

            George King (1955)
            Article 0 comments Cited 11 times – based on 0 reviews     Review now
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              A case of right upper abdominal pain misdiagnosed on computerized tomography.

              Seema Singh, Ashesh Jha, Naveen Sharma … (2014)
              Right upper abdominal pain is a common symptom in patients presenting to surgery emergency. Most of these cases can be diagnosed accurately on clinical evaluation or imaging. We report an unusual case of right upper abdominal pain, which could not be diagnosed correctly pre-operatively despite using various imaging modalities.
              Article 0 comments Cited 9 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Carissa McGuin
                Yagan Pillay
                Journal
                Journal ID (nlm-ta): J Surg Case Rep
                Journal ID (iso-abbrev): J Surg Case Rep
                Journal ID (publisher-id): jscr
                Title: Journal of Surgical Case Reports
                Publisher: Oxford University Press
                ISSN (Electronic): 2042-8812
                Publication date Collection: April 2023
                Publication date (Electronic): 12 April 2023
                Publication date PMC-release: 12 April 2023
                Volume: 2023
                Issue: 4
                Electronic Location Identifier: rjad185
                Affiliations
                College of Medicine, University of Saskatchewan , Saskatoon, Canada
                Department of Surgery, University of Saskatchewan , Saskatoon, Canada
                Author notes
                Correspondence address. Department of General Surgery, University of Saskatchewan, Health Sciences Building, 107 Wiggins Rd B419, Saskatoon, Saskatchewan S7N 0W8, Canada. Tel: +1-306-9668641; E-mail: yagan2pillay@ 123456yahoo.ca

                Dr McGuin is the primary author for the article.

                Article
                Publisher ID: rjad185
                DOI: 10.1093/jscr/rjad185
                PMC ID: 10097608
                SO-VID: ccc4d8b8-287d-49f4-ab58-85e1696f9fb4
                Copyright © Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 5 March 2023
                Date accepted : 15 March 2023
                Page count
                Pages: 3
                Categories
                Subject: Case Report
                Subject: AcademicSubjects/MED00910
                Subject: jscrep/0160

                Keywords: subhepatic appendix,interlobar bridge,hepatic bridge
                Data availability:
                Keywords: subhepatic appendix, interlobar bridge, hepatic bridge

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