Complicated Epigastric Appendicitis Managed Laparoscopically: A Case Report

Ectopic topography of the appendix is a rare anatomical variation that often results in atypical clinical presentations. We present the case of an 11-year-old boy who presented with right upper abdominal pain for 48 hours, accompanied by nausea and vomiting. Clinical examination revealed localized peritonism in the epigastric region. Imaging demonstrated a perforated appendix in an unusual epigastric location, complicated by lump formation and peri-appendiceal fluid collection. Diagnostic laparoscopy confirmed the ectopic position of the appendix. A laparoscopic appendectomy was performed successfully with an uneventful post operative course. This case highlights the diagnostic dilemma posed by ectopic appendicitis, particularly in pediatric patients presenting with atypical symptoms. Cross-sectional imaging, particularly CECT, plays a pivotal role in establishing the diagnosis and guiding surgical planning with laparoscopy offering the dual advantage of diagnostic confirmation and definitive treatment.