Harris Saeed, Ahmad Murtaza, Farooque Ahmed Haidari, Najam Uddin, Zia Salman Faruqui.
Acute appendicitis: an atypical presentation as left lower quadrant pain in setting of undiagnosed intestinal malrotation with associated vascular anomalies and left isomerism.
Pak J Radiol Jan ;32(4):249-53.

Acute appendicitis is one of the most frequent causes of acute right lower quadrant abdominal pain requiring emergency surgical intervention. Clinical examination and routine blood tests are sufficient for a provisional diagnosis, with CT scan as the most sensitive modality for diagnostic confirmation. Rare instances of appendicitis presenting as epigastric or left quadrant pain in cases of undiagnosed intestinal malrotation particularly in adults may present as a diagnostic dilemma and may at times even progress to catastrophic outcome. We report a case of 39 years old male patient with undiagnosed intestinal malrotation presenting with a recent history of left lower quadrant pain where acute appendicitis and associated left isomerism and aberrant vascular anomalies were ultimately grasped on the abdominal CT examination.

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