Appendico-ileal knotting resulting in closed-loop obstruction in a child

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Updated: Sep 28, 2026

Murine Ileocolic Bowel Resection with Primary Anastomosis
08:49

Murine Ileocolic Bowel Resection with Primary Anastomosis

Published on: October 29, 2014

Albert D Yang1, Chien-Hsing Lee

  • 1Department of Radiology, Changhua Christian Hospital, 135 Nan Siau Street, Changhua, Taiwan 50050, Republic of China. 27730@cch.org.tw

Pediatric Radiology
|November 26, 2002
PubMed

Insights

A rare case of appendiceal knotting caused a strangulated closed-loop obstruction in a child. This unusual presentation of pediatric intestinal obstruction highlights the appendix

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Pathology
  • Surgical Emergencies

Background:

  • Intestinal obstruction is a common surgical emergency in children.
  • Appendiceal abnormalities are rare causes of pediatric intestinal obstruction.

Observation:

  • A 1-year 7-month-old boy presented with acute severe vomiting and abdominal pain.
  • Barium enema showed a caecal mass and a 'bird's-beak' sign at the ileocaecal junction.

Findings:

  • Surgery revealed an unusually long, necrotic appendix strangulating the terminal ileum.
  • This resulted in a closed-loop obstruction without evidence of torsion.

Implications:

  • This case represents the first documented instance of appendiceal knotting causing terminal ileum strangulation.
  • Highlights the importance of considering rare appendiceal pathologies in pediatric intestinal obstruction.

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