Vascular complications during appendectomy: severe adhesion of the appendix to the right iliac artery: a case report

Area of Science:

• Surgical Gastroenterology
• Vascular Surgery
• Anatomic Pathology

Background:

• Appendicitis is a frequent cause of acute abdominal pain.
• Rarely, appendicitis can lead to adhesions involving adjacent vascular structures, such as the internal iliac artery.
• Such adhesions pose a risk of severe intraoperative hemorrhage during appendectomy.

Observation:

• A 65-year-old male presented with symptoms of acute appendicitis and a concurrent large pelvic mass.
• Intraoperative findings revealed an adhesion between the appendix and the right internal iliac artery.
• Severe bleeding occurred due to this adhesion, necessitating ligation of the internal iliac artery.

Findings:

• The case demonstrates a rare vascular complication of appendectomy.
• The adhesion between the appendix and the internal iliac artery was associated with a large pelvic mass.
• Successful management involved ligation of the internal iliac artery, with the patient recovering well.

Implications:

• This case underscores the necessity of meticulous preoperative assessment, particularly in cases with pelvic masses or suspected anatomical variations.
• Careful surgical planning is crucial to manage potential vascular adhesions during appendectomy.
• Early identification and strategic intervention for vascular complications are vital for favorable patient outcomes.