Internal hernia strangulated on appendicular tourniquet: a case report of an exceptional anomaly of the appendix revealed by a rare hernia

Abstract

Background Internal hernias and the appendicular tourniquet are two rare pathologies. Case presentation We report here a case of a 68-year-old obese patient, who has acute small bowel obstruction due to strangulated internal hernia through an appendicular tourniquet. This appendicular tourniquet results from the adhesion between the tip of the appendix and its body. This obstruction was complicated by plugged perforation. Resection of the small bowel segment was performed, in addition to appendectomy, lavage, and drainage. The postoperative recovery was uneventful. Conclusion Acute bowel obstruction secondary to strangulation of an internal hernia through an appendicular tourniquet is exceptional.

Appendiceal knotting causing small bowel obstruction: A rare case report

“…Similar to our cases, multiple studies had reported ileo-appendicular knotting as one of the rare mechanical causes of small bowel obstruction [4] , [5] , [6] , [7] , [9] , [10] . It happens whenever an appendix wraps around an intestine, or its tip adheres with small bowel, cecum, or posterior peritoneum forming a ring-like structure [7] , [9] .…”

Appendicular ring: an unusual cause of mechanical small bowel obstruction

“…What we describe in this case report is the formation of an ‘appendicular ring’ by which the inflamed appendix wraps around the terminal ileum, resulting in a mechanical distal small bowel obstruction. This has previously been reported in a small subset of patients 5–9 …”

Strangulated Internal Hernia through Appendicular Tourniquet/Ring: Unusual Cause of Intestinal Obstruction

“…Appendicular tourniquet is the formation of a ring/loop by the adhesion of its tip to ileocecal junction secondary to inflammation. To date, 17 cases have been described in literature by Ismail [16] and Chowdary [6]. Adhesion of the appendicular tip are formed by the inflammation of appendix itself or may result from peritoneal reaction [10].…”