Sarang Gotecha, Bharadwaj R N, Balaji Dhaigude, Priyanka Malekar.
Left sided perforated appendicitis in an adult with malrotated gut.
Pak J Surg Jan ;28(3):239-40.

The most common surgical emergency is acute appendicitis that requires urgent surgical intervention in majority of emergency departments. Intestinal malrotation is not a common surgical entity. Left sided lower abdominal pain commonly raises the possibility of acute diverticulitis. We present a very rare case of 50 year old male patient who presented in Emergency Room of our hospital with left sided abdominal pain, vomiting and constipation. His abdominal examination revealed tenderness and rebound tenderness left iliac fossa. White cell count was elevated to 11500. Chest and abdominal radiograph did not reveal gas under diaphragm. Emergency laparotomy revealed midgut malrotation with gangrenous appendix in the left iliac fossa. Appendicectomy done and the patient has uneventful recovery. Conclusion: Th ough left sided appendicitis is a very rare surgical entity, one should always have high index of suspicion in such conditions so that early surgical intervention may save the life of an individual.

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