Subhepatic acute appendictits in a 10-year-old male child; typical presentation with atypical location: A case report.

Acute appendicitis, the most frequent emergency in digestive surgery, is a well-known pathology children and young adults. Its diagnosis presents some difficulties elderly. Appendicitis taking place subhepatic space (i.e., appendicitis) largely not common, it occurs as result of intestinal malrotation and/or mal-descent cecum during embryonic development. In our case 10 year old male child has presented department Pakistan Railway Hospital, with complaints pain at right iliac fossa, associated nausea three episodes vomiting. The also had decreased oral intake since developing pain. On examination, pulkse rate 100 beats per min blood pressure 100/60mmHg. abdomen was soft marked tenderness fossa along guarding lower abdomen. There rebound psoas sign positive. After optimization open appendectomy planned, caecum found to be reaching border liver upon mobilizing caecum, appendix located sub-he patic retrocecal position (Image 1). markedly inflamed tortuous its course adhesions attaching wall caecum. It been concluded that among 0.009 percent acute appendicitis presentation 10-year-old an addition but typical symptoms appendicitis.