Unusual manifestation of acute retrocecal appendicitis: Pericholecystic fluid

Subhepatic-retrocaecal appendicitis is a rare entity in which the diagnosis is challenging. In patients presented with right abdominal pain with atypical clinical, laboratory and ultrasound (US) findings, acute appendicitis should be eliminated with computed tomography (CT). Multi detector CT (MDCT) can be used effectively for the diagnosis of retrocaecal appendicitis without additional preparation or focused examination. Here we present a patient of acute subhepatic-retrocaecal appendicitis in whom clinical and US findings mimicked acute cholecystitis. To the best of our knowledge, there is no previous report related to acute appendicitis presented with only pericholecystic fluid and could be diagnosed with MDCT. In conclusion; retrocaecal-subhepatic appendicitis is a rare condition which might be presented with atypical clinical, laboratory and radiological signs. US is usually insufficient for the definitive diagnosis. In this situation MDCT could be a rapid and efficient tool for localizing the appendix and for differential diagnosis.