A Case of Strangulated Obstruction After Antibiotic Therapy for Appendicitis

Abstract

An 85-year-old man who had formerly received antibiotic therapy for appendicitis and undergone no laparotomy was referred to our hospital with the diagnosis of strangulated obstruction seen on computed tomography. A laparotomy revealed that the tip of the appendix had adhered to the small intestinal mesentery, an adjacent loop of the small intestine was incarcerated through the hole made by that adhesion, and the incarcerated intestine exhibited ischemic change. However, the color and peristalsis of the ischemic intestine improved after release of the fibrous adhesion between the appendix and the mesentery. Therefore, resection of the affected intestine could be avoided and an appendectomy was performed on its own. Although appendicitis can cause paralytic ileus or adhesive intestinal obstruction after appendectomy, strangulated obstruction caused by appendicitis has been rarely described. We herein report on a case of strangulated obstruction after antibiotic therapy for appendicitis with a review of the relevant literature.