A Case of Sub Hepatic Perforated Appendicitis Presented as Multiple Gas Containing Subcapsular Hepatic Abscesses

Appendicitis is the most common acute surgical condition of the abdomen. The diagnosis of acute appendicitis can often be made clinically. When the appendix is situated in an abnormal position, the diagnosis of acute appendicitis becomes difficult. Delayed diagnosis or misdiagnosis of subhepatic appendicitis might lead to perforations of the appendix, which is a clinical emergency. Liver abscess as a complication of appendicitis was first described in 1898 by Dieulafoy. The majority of pyogenic liver abscesses are caused by infection originating in the biliary or intestinal tracts. Pyogenic liver abscess is a rare complication of acute appendicitis. Multiple pyogenic liver abscesses are not frequently reported in the literature, but the overall mortality is high, if left with no treatment or not treated early.

We have reported a case of subhepatic perforated appendix presented with multiple subcapsular liver abscesses.