Duodenal Obstruction Caused by Acute Appendicitis with Intestinal Malrotation in a Child

The American Journal of Case Reports
Şenol Biçer, Ali Çelik

Abstract

In patients with intestinal malrotation, the diagnosis of acute appendicitis can be difficult due to atypical presentation. Duodenal obstruction caused by acute appendicitis with the presence of malrotation has rarely been reported in children. We report the case of a 14-year-old male patient with bilious vomiting and abdominal distension. A diagnosis could not be made by computed tomography, ultrasonography, or endoscopy. We observed a dilated stomach and malrotation in laparotomy. The caecum was in the right upper quadrant, and an inflamed appendix was located in the subhepatic region. After the appendectomy, the cecum was mobilized and fixed in the right lower quadrant. In children with intestinal malrotation, acute appendicitis can present as duodenal obstruction without abdominal pain, and standard imaging methods can miss the correct diagnosis.

References

Oct 1, 1958·A.M.A. Archives of Surgery·W B KIESEWETTER, J W SMITH
Apr 2, 2004·Pediatrics International : Official Journal of the Japan Pediatric Society·Mustafa ImamogluYaşar Sen
Jul 27, 2007·JAMA : the Journal of the American Medical Association·David G BundyHenry E Rice
Jun 9, 2012·International Journal of Surgery Case Reports·Charbel M TawkSeba Mehanna
Jan 21, 2014·International Journal of Surgery Case Reports·Mehmet OdabasiM A Tolga Muftuoglu

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Citations

Aug 24, 2016·World Journal of Radiology·Heather I GaleKatherine Nimkin
Feb 20, 2018·Asian Journal of Endoscopic Surgery·Belén Aneiros CastroAndrés Gómez Fraile

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Methods Mentioned

BETA
X-ray

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