A case of abdominal wall abscess caused by a small bowel diverticulum associated with a strangulated ileus due to a band between an abdominal wall abscess and the ileum

Abstract

A 73-year-old male was admitted with an ileus and an abdominal wall abscess. His past medical history included alcoholic dementia and abdominal surgery due to a gastric ulcer at 56 years of age. The patient was given decompression therapy using a long ileus tube ; the ileus improved within one week. Although the abdominal wall abscess was incised and drained, the treatment was not successful. Thus ileus recurred along with signs of a strangulated obstruction. Emergency surgery was done. During surgery, a strangulated intestinal ileus due to an adherent band between the abdominal wall and the ileum located 50cm from the ileum end on the antimesenteric side was found. The adherent band connected the abdominal wall abscess to the ileum. The band was cut, the strangulated intestinal obstruction was corrected without resection, and the abdominal abscess was removed. The patient's postoperative course was uneventful. In pathology the abscess wall and the small bowel wall were clearly demarcated. It is likely that the abdominal abscess originated in the small bowel diveticulum. We present a very rare case of an abdominal wall abscess caused by an small bowel diverticulum associated with a strangulated ileus due to a band located between the abscess and the ileum. A review of the literature is also provided in this paper.