B. Sobha Rani1 L. Latchu2 K. Lokesh3 K. V. Madhusudhan4 Y. Mahesh Babu5
A 45 year male patient presented to emergency ward with pain abdomen from 2 days, vomiting from 1 day. On examination diffuse abdominal tenderness was noted with no guarding and no rigidity. USG showed dilated bowel loops with subhepatic appendicitis. So patient was taken up for surgery thinking in favour of appendicular pathology. In the laparotomy to our surprise there was no appendix present and there was distorted anatomy. On careful examination it was noted that there was absent caecum and ascending colon with a rudimentary appendix. Ileum was ending directly in the transverse colon in the sub hepatic region. Search was made to find the pathology and an adhesion band was noted between the bowels with small bowel dilatation and bowel was viable. Band was removed and abdomen was closed with drains. Post op recovery was good and was discharged on 10th POD.