Purpose <p>Subhepatic cecums are rare conditions (0.3–0.5% of live births) that result from a malrotation event during embryologic development. Although this condition is uncommon, it presents unique challenges for diagnosing appendicitis due to the appendix being displaced to the right upper quadrant instead of its typical right lower quadrant location.</p> Methods <p>An 85-year-old male cadaver with a medical history significant for type 2 diabetes mellitus, atrial fibrillation, systolic congestive heart failure, and severe protein malnutrition was used during routine dissections of the gastrointestinal system.</p> Results <p>A subhepatic cecum was identified with a vermiform appendix situated just below the liver. Further examination revealed a unique variation in the pathways of the ileocecal artery to accommodate the malrotation.</p> Conclusion <p>Despite being rare, understanding this developmental variation is beneficial for the accurate diagnosis and treatment of patients with unusual presentations of appendiceal and colonic pathologies.</p>

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An unusual subhepatic cecum identified during cadaveric dissection: relevance for clinical diagnosis and anatomy education

  • Jackson Clayton,
  • Jacob Krews,
  • Gabriella Fouchi,
  • Devon Smith,
  • Matthew D. Overturf

摘要

Purpose

Subhepatic cecums are rare conditions (0.3–0.5% of live births) that result from a malrotation event during embryologic development. Although this condition is uncommon, it presents unique challenges for diagnosing appendicitis due to the appendix being displaced to the right upper quadrant instead of its typical right lower quadrant location.

Methods

An 85-year-old male cadaver with a medical history significant for type 2 diabetes mellitus, atrial fibrillation, systolic congestive heart failure, and severe protein malnutrition was used during routine dissections of the gastrointestinal system.

Results

A subhepatic cecum was identified with a vermiform appendix situated just below the liver. Further examination revealed a unique variation in the pathways of the ileocecal artery to accommodate the malrotation.

Conclusion

Despite being rare, understanding this developmental variation is beneficial for the accurate diagnosis and treatment of patients with unusual presentations of appendiceal and colonic pathologies.