Navigating Uncommon Presentations of Appendicitis: A Case Series on Abdominal Wall Cellulitis, Gluteal Involvement, and Perinephric Abscesses

Acute appendicitis can rarely perforate extraperitoneally, tracking into the abdominal wall, gluteal region, or perinephric space, leading to delayed diagnosis. We report three such cases managed at our tertiary centre between January 2022 and December 2024, detailing clinical features, imaging findings, interventions (drainage and appendectomy), microbiology, and outcomes. All patients recovered fully with no recurrences at follow up. Awareness of these atypical presentations and prompt cross-sectional imaging with tailored drainage and appendectomy can minimize morbidity. Limitations include single-centre, retrospective design, and small sample size.