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Case report--mechanical bowel obstruction with appendicitis without strangulation and leukocytosis
Anil Khetarpal1, Ayush Khetarpal1
1Department- General Surgery, Institution Khetarpal Hospital, India.
Abstract:
Intestinal obstruction is a common surgical emergency caused by varied conditions. Acute appendicitis is considered as one of the unusual cause of intestinal obstruction especially functional and very few cases of mechanical obstruction. Here we report a Case of 62-years-old male who presented here with a clinical picture of small bowel obstruction. On laparotomy, there was a dilated gut with long appendix having inflamed tip buried into adjoining mesentery and then appendectomy was done and obstruction was relieved. Also, bowel was found to be viable hence simple appendectomy was found to be sufficient treatment. Histopathological findings was suggestive of chronic fibrosing appendicitis. Hence, in cases of bowel obstruction in an elderly patients with clinical examination which was not typical for appendicitis can be managed with laparotomy and simple appendectomy when early intervention is made to avoid the risk of ischemia and gangrenous changes in intestinal mesentery which may require resection in later stages.
Insights
Appendicitis can unusually cause intestinal obstruction. A case report details successful surgical relief of small bowel obstruction in an elderly male via appendectomy for chronic fibrosing appendicitis.
Area of Science:
- Gastroenterology
- Surgical Emergencies
- Abdominal Surgery
Background:
- Intestinal obstruction is a frequent surgical emergency with diverse etiologies.
- Appendicitis is an uncommon cause of intestinal obstruction, typically functional, rarely mechanical.
Observation:
- A 62-year-old male presented with symptoms of small bowel obstruction.
- Laparotomy revealed a dilated bowel and a long appendix with an inflamed tip adhered to the mesentery.
Findings:
- Simple appendectomy was performed, relieving the obstruction.
- The bowel remained viable, indicating appendectomy was sufficient treatment.
- Histopathology confirmed chronic fibrosing appendicitis.
Implications:
- Early surgical intervention, including appendectomy, can resolve bowel obstruction caused by appendicitis in elderly patients.
- Timely management prevents intestinal ischemia and gangrene, avoiding the need for bowel resection.
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