Ischemic appendicitis due to pelvic adhesions: a case report

Acute appendicitis is one of the most common etiologies of a surgical abdomen. The lifetime risk is estimated to be 7%. Over 300 000 appendectomies occur annually in the USA. The pathophysiology of appendicitis in most patients is believed to be caused by outflow obstruction of the appendiceal lumen leading to increased intraluminal pressure, venous congestion and mucosal ischemia. This can occur due to a variety of internal obstructive causes such as a fecalith, lymphoid hyperplasia, parasites or a tumor. To date, no case reports describing appendicitis secondary to external compression of the appendix leading to outflow obstruction been documented in the literature. This case report describes a 61-year-old female who had a thick, adhesive band compressing the base of her appendix, which created external outflow obstruction leading to the development of appendicitis.