Appendico-ileal knotting mimicking adhesive bowel disease

Abstract

Appendico-ileal knotting is a very rare and widely unknown cause of closed loop bowel obstruction. In most cases it is discovered incidentally during surgery. We report a 59 year old female with a previous history of a total abdominal hysterectomy who presented with features of intestinal obstruction and was thought to suffer from postoperative adhesions. At laparotomy, appendico-ileal knotting was found; after appendectomy, she made a full recovery. Appendico-ileal knotting should be known as a possible differential diagnosis when managing patients with features of intestinal obstruction and symptoms or signs of appendicitis.

Zusammenfassung

Eine „Verknotung“ zwischen Appendix und Ileum ist eine sehr seltene und weithin unbekannte Ursache einer intestinalen Obstruktion; die Diagnose wird meist erst intraoperativ gestellt. Wir berichten über eine 59-jährige Patientin mit der Vorgeschichte einer totalen abdominellen Hysterektomie. Sie stellte sich mit Zeichen einer intestinalen Obstruktion vor, die als Folge von postoperativen Verwachsungen interpretiert wurden. Intraoperativ wurde eine oben beschriebene Verknotung gefunden; nach der Appendektomie war die Patientin beschwerdefrei. Eine Verknotung zwischen Appendix und Ileum ist eine mögliche Differenzialdiagnose bei Patienten mit Zeichen einer intestinalen Obstruktion und Symptomen oder Befunden, die auf eine akute Appendizitis hindeuten.

Schlüsselwörter

Appendizitis - Appendix-Ileum-Verknotung - Appendix-Band-Syndrom - Adhäsionen

Key words

appendicitis - appendico-ileal knotting - appendiceal tie syndrome - adhesions

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