Intestinal Obstruction Due to Acute Appendicitis

Abstract

Even though acute appendicitis is a well-known disease in the surgical field, it causing mechanical bowel obstruction is a rare entity and very little specific research on this aspect. We present a case of an 80-year-old gentleman with a 6-day history of diffuse abdominal pain with distension associated with bilious vomiting. There were no associated symptoms like fever, weight loss, bladder disturbances or similar complaints in the past. There was no history of any medical illness and no previous abdominal surgery. On general physical examination, he was alert, conscious, oriented and afebrile with heart rate 98/min, blood pressure 140/90 mm Hg. On per abdomen examination, it was distended with diffuse tenderness all over the abdomen. Initially, a diagnosis of small bowel obstruction was made and later CT abdomen and pelvis added acute appendicitis to our diagnosis. After initial management, he was taken for emergency midline laparotomy which revealed inflamed appendix with its tip kinking the distal ileum causing obstruction. Adhesions were released and appendicectomy was done. The bowel was found viable and no resection was done. Histopathology confirmed acute appendicitis. Postoperative recovery was uneventful. We report this case as it is very rare with less than 50 cases reported all over the world.