Role of multidetector computed tomography (MDCT) in diagnosis of subhepatic appendicitis

BackgroundAcute appendicitis is a common surgical condition that is usually managed with early surgery, and is associated with low morbidity and mortality. However, some patients may have atypical symptoms and physical findings that may lead to a delay in diagnosis and increased complications.Ascending subhepatic appendicitis presenting with right upper abdominal pain may be clinically indistinguishable from acute pathology in the gallbladder, liver, biliary tree, right kidney and right urinary tract.Aim of the workTo study the role of multidetector computed tomography in diagnosis of subhepatic appendicitis.Subjects & methodsIn the current study, we included fifteen patients diagnosed radiologically and confirmed surgically as subhepatic appendicitis.Ultrasonography followed by multidetector computed tomographic examination were performed to all patients before surgery.ResultsThe clinical diagnosis of the patients included in this study at presentation was acute cholecystitis in four patients, pyelonephritis in three, and ureteric colic in three. Five patients were referred with uncertain diagnosis.The presence of subhepatic appendicitis was confirmed sonographically only in two patients. Computed tomography (CT) identified correctly subhepatic appendicitis in all cases.ConclusionOur study indicates the usefulness of multidetector CT in diagnosing atypical ascending subhepatic appendicitis.