Presentation
Acute abdominal pain for 3 days, post-appendectomy 3 years ago.
Patient Data
Reversal of SMA and SMV relationship noted with small bowel loops towards the right and large bowel to left suggestive of intestinal non-rotation.
A blind-ending bowel loop noted arising from cecum at the midline hypogastrium with calculus at base suggesting swollen appendicular stump with appendicolith.
Case Discussion
Findings of stump appendicitis were confirmed intra-operatively. Differential diagnosis included Meckel diverticulitis.
Non-rotation is a rare incidental abnormality in which entire small bowel is placed to the right of midline and large bowel to left. This leads to an aberrant position of appendix and cecum.