Small bowel obstruction caused by appendiceal tourniquet

Deshmukh, Santoshkumar N.; Maske, Audumber N.; Bote, Sachin Madhukar; Parashi, Hrishikesh Sukhadeo

doi:10.1016/j.amjsurg.2010.03.022

Cited by 8 publications

(7 citation statements)

References 2 publications

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“…Laboratory tests performed revealed normal potassium and sodium levels, with elevated level of serum creatinine. A leukocytes count was found to be within the normal range in our study, although it has been reported to be elevated in some series and was mainly attributed to small bowel ischemia [3, 6, 10]. Hence, leukocytosis is not a reliable indicator of acute appendicitis associated with mechanical small bowel obstruction.…”

Section: Discussioncontrasting

confidence: 75%

“…We observed that the picture of intestinal obstruction dominates in our case scenario and for a majority of patients with AT as well. Therefore, clinical examination is usually not typical for appendicitis, as only physical findings of intestinal obstruction are evident, while right iliac tenderness is only evident in a few cases and is usually attributed to small bowel ischemia [3, 6, 7, 9, 10].…”

Section: Discussionmentioning

confidence: 99%

“…In this case, the bowel was found to be viable intraoperatively, as has been reported in a few series, and this may be due to early presentations of the cases seeking treatments and/or early interventions. Simple appendectomy was found to be sufficient treatment for such cases [10, 11]. Laparotomy was the commonest approach used in almost all the cases with the exception of one case that was managed laparoscopically.…”

Section: Discussionmentioning

confidence: 99%

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Mechanical small bowel obstruction due to appendiceal tourniquet: a case report and review of literature

et al. 2019

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Background Acute appendicitis is known to cause intestinal obstruction. The presentation is commonly due to functional obstruction, but on very rare occasions it presents as mechanical obstruction, especially closed loop. Case presentation We report a case of a 59-year-old Egyptian man who presented with symptoms suggestive of intestinal obstruction. On examination, he was afebrile with distended tender abdomen with no obvious hernias. There was no history of previous abdominal surgery. Laboratory investigations were within normal range except for elevated serum creatinine levels. Plain erect X-ray and computed tomography scan of his abdomen indicated mechanical small bowel obstruction. Preoperative preparations with administration of intravenously administered fluids and antibiotics were done for exploratory laparotomy. The operation was approached through a midline incision, revealing dilated small bowel loops with a terminal ileal loop occluded by a ring of his appendix. The appendicular tip was adherent to small bowel mesentery by adhesive band (appendiceal tourniquet). Release of the band with simple appendectomy was done; a segment of ileal bowel loop was congested but regained its viability after 5 minutes’ application of gauze soaked in warm saline. His abdomen was closed in layers and one drainage tube left in situ . Paralytic ileus was the only postoperative complication which was relieved after 2 days. He was started on orally administered fluids on the third postoperative day, and discharged on the fifth postoperative day. Conclusion Acute appendicitis should be suspected as a cause of mechanical intestinal obstruction in an elderly patient with no obvious diagnostic cause, and can be managed with simple appendectomy when an early intervention is made.

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mechanical small bowel obstruction due to appendiceal tourniquet: a case report and review of literature

et al. 2019

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“…Some forms of appendicitis can cause bowel obstruction [1, 2]. Among these forms, some authors have described the appendicular tourniquet [3, 4]. It is an ileocecal appendix that forms a loop in which the small bowel can penetrate and perform an internal hernia.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…2 The physiopathology of mechanical causes is the mechanical pressure on the adjacent small intestinal segment. 6 The etiology of the obstruction in our first patient was paralytic, whereas in our second patient it was mechanical, which is a very rare, as we mentioned above.…”

Section: Discussionmentioning

confidence: 80%

Acute appendicitis presenting with small intestinal obstruction findings - 2 cases report

Altıntoprak¹,

Dikicier²,

Çakmak³

et al. 2014

Sakarya Med J

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Akut apandisit ve ince barsak obstrüksiyonları acil servislerde sık karşılaşılan cerrahi problemlerdir. Akut apandisit nadiren ince barsak obstrüksiyonu bulguları ile prezente olabilir. 68 yaşında kadın ve 42 yaşında erkek hastalar intestinal obstrüksiyon bulguları nedeniyle acil serviste değerlendirildi. Hastaların birinde obstrüksiyon nedeni perfore apandisit nedenli paralitik iken, diğerinde uzun apendiksin terminal ileuma basısı nedeniyle mekanikti. Her iki hastaya da apendektomi uygulandı ve ameliyat sonrası dönemleri sorunsuz seyretti. Akut apandisit en sık karşılaşılan akut karın sendromu etyolojisi olmasına rağmen nadiren beklenmedik klinik bulgularla prezente olabilir. Özet AbstractOlgu Sunumu / Case Report

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Small bowel obstruction caused by appendiceal tourniquet

Cited by 8 publications

References 2 publications

Mechanical small bowel obstruction due to appendiceal tourniquet: a case report and review of literature

Mechanical small bowel obstruction due to appendiceal tourniquet: a case report and review of literature

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

Acute appendicitis presenting with small intestinal obstruction findings - 2 cases report

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