Background: Facing lateral pouch appendicitis (LPA) is unusually encountered by pediatric surgeons, and usually, these cases carry intraoperative challenges due to their unpredictable location and are difficult to locate. Pediatric surgeons should be aware of this and anticipate encountering such cases. Diagnosis of acute appendicitis is based on clinical, laboratory, and imaging modalities. Moreover, the same diagnostic strategy is applied for LPA, but with more challenges since its location sometimes gives atypical presentations, with difficulty in finding the appendix during the ultrasonographic radiological imaging.
Case Presentation: A total of three cases of acute appendicitis were presented, which were managed surgically. Intra-operatively, an appendix was found retroperitoneally with its base in the posterior wall of the cecum, while the terminal ileum was set in a retroperitoneal fashion alongside the lateral abdominal wall. This is an unusual location, which carries challenges during dealing with such cases.
Conclusion: It was assumed that this is a considerable health concern that needs to be investigated. Clarifying the outcome in these cases, and describing the intraoperative findings, would help us understand the condition. Increase the awareness around the health care community, in order to manage these cases properly in terms of understanding the diagnostic challenges, and surgical interventions, and to prevent or decrease the intra-operative complications.
Key words: Acute appendicitis, lateral pouch appendicitis, abnormal position, appendectomy, case report.
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