{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T20:01:01Z","timestamp":1785268861339,"version":"3.55.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Subhepatic appendicitis is a rare anatomical variant that mimics hepatobiliary pathology, leading to diagnostic delay and technical difficulty at surgery. We describe a 69-year-old man who underwent emergency laparoscopic appendicectomy for sepsis, complicated by dense subhepatic adhesions resulting in incomplete resection and a retained appendiceal tip. Histopathological examination unexpectedly demonstrated moderately differentiated appendiceal adenocarcinoma with isolated loss of postmeiotic segregation increased 2 expression. Three weeks later, the patient re-presented with recurrent sepsis due to pyogenic liver abscesses and a hepatic lesion suspicious for metastatic disease. Multidisciplinary assessment led to radical right hemicolectomy, cholecystectomy, and limited liver resection. Final histopathology confirmed locally advanced disease with direct T4 invasion into the liver and clear (R0) margins. This case highlights the need to consider subhepatic appendicitis in unexplained right upper quadrant sepsis and emphasizes the importance of early multidisciplinary management when retained appendiceal tissue is suspected, as radical resection may be curative.<\/jats:p>","DOI":"10.1093\/jscr\/rjag633","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:55:15Z","timestamp":1783511715000},"source":"Crossref","is-referenced-by-count":0,"title":["Subhepatic retained appendiceal tip harbouring adenocarcinoma: a surgeon\u2019s dilemma"],"prefix":"10.1093","volume":"2026","author":[{"given":"Immanuella","family":"Owusu-Ansa","sequence":"first","affiliation":[{"name":"Department of Surgery, Nepean Hospital , Somerset Street, Kingswood, NSW 2747, \u00a0","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Pappas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nepean Hospital , Somerset Street, Kingswood, NSW 2747, \u00a0","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbie","family":"El-Bazouni","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nepean Hospital , Somerset Street, Kingswood, NSW 2747, \u00a0","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Misevska","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney , Sydney, Camperdown, NSW 2006 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewan","family":"McDermid","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nepean Hospital , Somerset Street, Kingswood, NSW 2747, \u00a0","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6827-0088","authenticated-orcid":false,"given":"Femi E","family":"Ayeni","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nepean Hospital , Somerset Street, Kingswood, NSW 2747, \u00a0","place":["Australia"]},{"name":"Faculty of Medicine and Health, The University of Sydney , Sydney, Camperdown, NSW 2006 ,","place":["Australia"]},{"name":"Nepean Institute of Academic Surgery, Nepean Clinical School, The University of Sydney , Sydney, 62 Derby Street, Kingswood, NSW 2747 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Vagg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nepean Hospital , Somerset Street, Kingswood, NSW 2747, \u00a0","place":["Australia"]},{"name":"Faculty of Medicine and Health, The University of Sydney , Sydney, Camperdown, NSW 2006 ,","place":["Australia"]},{"name":"Nepean Institute of Academic Surgery, Nepean Clinical School, The University of Sydney , Sydney, 62 Derby Street, Kingswood, NSW 2747 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026072815134339600_ref1","first-page":"1101","article-title":"Subhepatic appendicitis: a rare anatomical variation","volume":"30","author":"Khan","year":"2020","journal-title":"J Coll Physicians Surg Pak"},{"key":"2026072815134339600_ref2","first-page":"421","article-title":"Management of complex appendicitis in atypical anatomical locations","volume":"95","author":"Roberts","year":"2025","journal-title":"ANZ J Surg"},{"key":"2026072815134339600_ref3","first-page":"595","article-title":"Adenocarcinoma of the appendix: a rare case report","volume":"17","author":"Mishra","year":"2021","journal-title":"J Cancer Res Ther"},{"key":"2026072815134339600_ref4","first-page":"153723","article-title":"Mismatch repair protein expression in appendiceal mucinous neoplasms","volume":"229","author":"Xavier-Junior","year":"2022","journal-title":"Pathol Res Pract"},{"key":"2026072815134339600_ref5","first-page":"341","article-title":"Survival outcomes used to validate version 9 of the American Joint Committee on Cancer staging system for appendiceal adenocarcinoma","volume":"73","author":"Harkins","year":"2023","journal-title":"CA Cancer J Clin"},{"key":"2026072815134339600_ref6","first-page":"109281","article-title":"R0 resection for locally advanced appendiceal adenocarcinoma: a clinical review","volume":"115","author":"Nishizawa","year":"2024","journal-title":"Int J Surg Case Rep"},{"key":"2026072815134339600_ref7","first-page":"112","article-title":"Multivariable analysis of survival predictors in epithelial appendiceal neoplasms","volume":"293","author":"McConkey","year":"2024","journal-title":"J Surg Res"},{"key":"2026072815134339600_ref8","first-page":"18","article-title":"Management of appendiceal adenocarcinoma: a systematic review","volume":"82","author":"Tustumi","year":"2020","journal-title":"Int J Surg"}],"container-title":["Journal of Surgical Case 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