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Retro-psoas appendicitis
  1. Bradley C Muncy1,
  2. Rachel Desimone2 and
  3. Federico G Seifarth1
  1. 1Division of Pediatric Surgery, WVU Medicine Children's Hospital, Morgantown, West Virginia, USA
  2. 2Division of Pediatric Surgery, Logan Health, Kalispell, Montana, USA
  1. Correspondence to Dr Federico G Seifarth; Federico.seifarth{at}


The vermiform appendix (VA) is known to exhibit a wide range of anatomic variability, with clinical presentation correlating with certain known anatomic positioning. To the best of our knowledge, we describe the second known case of a retro-psoas muscle VA variant and the first known case of appendicitis in such a location. Retroperitoneal access was obtained, and the appendix was freed from the intermuscular recess between the psoas and iliacus. The peritoneal defect was primarily repaired, and the patient was discharged on postoperative day 1 in good condition.

  • Gastrointestinal surgery
  • Paediatric Surgery

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: BCM, RD and FGS. The following author gave final approval of the manuscript: FGS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.