Atypical manifestations of acute retrocecal appendicitis in a child

We report a child of elongated retrocecal appendicitis who presented with abdominal pain over the right upper quadrant and circular skin erythema over the right flank. Sonography showed an elongated tubular structure over the right abdomen. By the location, relationship to adjacent tissue and origin of tubular structure, the sonographic findings were differentiated from those of other similar diseases, such as colonic duplication or Meckel's diverticulum. This case illustrates retrocecal appendicitis should be considered as one of the differential diagnoses for earlier surgical intervention if a patient exhibits such atypical clinical manifestations accompanied with an elongated tubule structure of the right abdomen by sonography.