Subhepatic caecum and appendix - a rare variant in an adult male cadaver

Abstract

AbstractIn unusual cases of malrotation or incomplete rotation of caecum , the appendix is not located in the lower right quadrant. When the caecum is high [subhepatic caecum] the appendix is located in the right hypochondriac region and the pain in these cases is located there, not in the lower right quadrant. In this position , the symptoms and signs of acute appendicitis may mimic acute cholecystitis, diagnosis in such cases is a great diagnostic challenge. The author observed this less frequent anomaly in a middle aged male cadaver. After opening the abdomen while tracing peritoneal reflections abnormality was identified. The caecum and appendix were present in relation with inferior surface of liver. Embryologically, the caecal swelling appears as a small conical dilation of the caudal limb of primitive intestinal loop and it is the last part of the gut to reenter the abdominal cavity. It is temporarily located in the right upper quadrant directly below the right lobe of liver. From here it descends into the right iliac fossa. The failure to descend leads to subhepatic caecum.