A case of acute appendicitis with duodenal stenosis accompanied by intestinal malrotation

Abstract

We report a case of acute appendicitis with duodenal stenosis accompanied by intestinal malrotation.
A 78-year-old man complaining of abdominal pain and fever was referred to our hospital after unsuccessful conservative therapy. An abdominal CT scan revealed a perityphlic abscess with acute appendicitis and intestinal malrotation where the ileocecal region was located at the ventral aspect of the descending portion of the duodenum. Since duodenal obstruction developed and inflammation became severe despite conservative treatment for three days, he underwent operation. At laparotomy, we found that the descending portion of the duodenum had been involved by the perityphlic abscess. We performed appendectomy and drainage, followed by side-to-side duodeno-jejunostomy because of fibrous duodenal stenosis resulting from long-term inflammation. Although he suffered from temporary anastomotic passage impairment, he was discharged from the hospital on the 29th day after the operation.