# Scimitar Syndrome Incidentally Identified During the Workup for Acute Appendicitis in a Young Adult Female: A Case Report

## TL;DR

A young woman with acute appendicitis was found to have Scimitar syndrome, a rare congenital lung condition, during surgery.

## Contribution

This case adds to the limited understanding of Scimitar syndrome in adults and highlights diagnostic challenges.

## Key findings

- Scimitar syndrome was incidentally identified during laparoscopic appendectomy in a 21-year-old female.
- Right lung hypoplasia, cardiac dextroposition, and partial anomalous pulmonary venous return were confirmed via CT imaging.
- Histopathology and cardiac assessments showed no abnormalities apart from the congenital condition.

## Abstract

While congenital pulmonary venolobar syndrome (CPVS), including Scimitar syndrome and horseshoe lung, is highly uncommon in adults, acute appendicitis is a common surgical emergency.

This case report emphasizes the difficulties in diagnosing patients and the possibility of misdiagnosis, highlighting the significance of clinical awareness for the best possible care. A laparoscopic appendectomy was performed on a 21-year-old female patient who presented with symptoms of acute appendicitis. During the procedure, a suspicious cecal tumor and a subserosal, dilated retrocecal appendix were observed. The patient was identified as having right lung hypoplasia, cardiac dextroposition, and partial anomalous pulmonary venous return (PAPVR), indicating the presence of Scimitar syndrome along with horseshoe lung. These findings were confirmed by post-operative CT imaging. The appendix histopathology and colonoscopy were unremarkable, and the cardiac assessment, including the electrocardiogram and echocardiogram, was also normal. Incidental CPVS in adults requires diligent recognition for optimal management. This case contributes to the limited research on adult manifestations of Scimitar syndrome and associated abnormalities, which is expanded by this instance.