Acute appendicitis in a patient with sub-hepatic, sub-serosal, and retroperitoneal location. An intraoperative management challenge.

Introduction: Appendicitis in patients with a sub-hepatic and retroperitoneal position is rare, often leading to delayed diagnosis and management due to its atypical presentation. A high index of clinical suspicion and the use of imaging modalities can improve the outcomes of patients with sub-hepatic appendicitis.

Case Presentation: A 20-year-old male presented with 36 h duration of right-sided abdominal pain, accompanied by nausea, vomiting, anorexia, and fever.