Atypically located incidental appendicitis during laparoscopic cholecystectomy

Appendicitis is the most common surgical emergency. It classically presents with periumbilical pain that localizes to the right lower quadrant and nausea, vomiting, anorexia, and fever. Acute appendicitis may result from an obstructing faecolith or some other mechanical blockage. However, appendicitis presenting with rare and misleading right upper quadrant pain may result in an initial false-negative diagnosis by the physician and even result in negative findings on computed tomography (CT) or ultrasound, increasing the risk of perforation/abscess formation and prolonged hospital stay. This report presents a case of atypical appendicitis during laparoscopic cholecystectomy where the correct diagnosis was not initially considered. Unusual localization was documented several times, otherwise known as classical localization of the appendix. Findings of acute appendicitis varied according to the localization of the appendix. The most common position was the retrocaecal region (65-70%). Other localizations were paraileal, postileal, promontoric, pelvic, subcaecal, paracolic and retrocaecal. These conditions were important to recognise, given that they may need additional specific management. This case report study showed atypical located incidental appendicitis during laparoscopic cholecystectomy.