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Intestinal malrotation/nonrotation with acute appendicitis

Case contributed by Ibrahim Alsheikh Deeb
Diagnosis certain

Presentation

Abdominal pain and fever

Patient Data

Gender: Male

Small bowel loops are in the right side of the abdomen. Colon is predominantly in the left side of the abdomen with cecum in the left lower quadrant.

There is reversed SMA/SMV relationship, with the SMV seen to the left of the SMA.

No signs of abdominal obstruction.

The appendix is in the lower abdomen to the left to the midline. It contains an appendicolith, distended with mural hyperenhancement and periappendiceal inflammatory fat stranding, consistent with acute appendicitis. No signs of perforation. No associated fluid collections.

Case Discussion

There are typical features of acute uncomplicated appendicitis seen in atypical location.

Patient underwent appendectomy.

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