Acute subumbilical appendicitis in a patient undiagnosed with intestinal malrotation: a case report.

INTRODUCTION

Acute appendicitis in the presence of intestinal malrotation is an uncommon and distinctive clinical condition. Herein, we present a rare case of subumbilical appendicitis resulting from previously undiagnosed intestinal malrotation.

CASE PRESENTATION: A 16-year-old Saudi Arab man with no known chronic illness presented with acute suprapubic abdominal pain accompanied by nausea and vomiting. The pain was gradual in onset, dull, nonradiating, and initially localized to the epigastric area before extending to the suprapubic region. The patient denied any history of bowel habit changes, urological symptoms, or prior abdominal surgeries. On physical examination, tenderness was noted over the epigastric and suprapubic regions. Contrast-enhanced abdominal computed tomography revealed intestinal malrotation with subumbilical appendicitis. The patient subsequently underwent an appendectomy. Histopathological analysis confirmed appendicitis with no features of malignancy. The postoperative course was uneventful, and the patient was followed up without complications.

CONCLUSION

Although appendicitis associated with intestinal malrotation is rare, it should be considered in patients presenting with acute abdominal pain and known or suspected malrotation. Prompt recognition and appropriate imaging are essential to avoid misdiagnosis and ensure timely surgical management.