Published: 2022-10-29

Subhepatic perforated subhepatic appendicitis versus acute cholecystitis: a diagnostic dilemma

Kean L. Koay, Mang Ning Ong, Zhen Yu Tok, Norjazliney Binti Ahmad Jafri, Ramesh R. Thangaratnam


Appendicitis, being one of the most common surgical problems, is often diagnosed clinically. The typical clinical sign elicited from a patient suffering from acute or perforated appendicitis includes: Rebound tenderness, Rovsing sign, Obturator sign, Psoas sign, and tenderness over the right iliac fossa. Cholecystitis, another common surgical problem, typically presents with tenderness over the right hypochondrium, and the typical sign associated with this condition is positive Murphy’s sign. In this report, we describe how a subhepatic perforated appendicitis can mimic acute cholecytstitis, both clinically and radiologically in an adult patient.


Appendicitis, Murphy’s sign, Surgery, Abdomen, Gallstone disease

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